Hypertension and diabetes on cognitive impairment: a case–control study in China

Abstract Background Cognitive impairment, hypertension and diabetes are prevalent chronic conditions in populations of older ages. Previous studies have shown that hypertension and diabetes are risk factors for the development of cognitive impairment. However, the impact of hypertension combined wit...

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Main Authors: Jing Wu, Xiangjun Yin, Weiqiang Ji, Yang Liu, Jing Tang, Han Zhang, Shige Qi, Jie Li, Li Lin, Xueqing Yang, Chengdong Xu, Qingfeng Du
Format: Article
Language:English
Published: BMC 2025-05-01
Series:Alzheimer’s Research & Therapy
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Online Access:https://doi.org/10.1186/s13195-025-01761-3
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author Jing Wu
Xiangjun Yin
Weiqiang Ji
Yang Liu
Jing Tang
Han Zhang
Shige Qi
Jie Li
Li Lin
Xueqing Yang
Chengdong Xu
Qingfeng Du
author_facet Jing Wu
Xiangjun Yin
Weiqiang Ji
Yang Liu
Jing Tang
Han Zhang
Shige Qi
Jie Li
Li Lin
Xueqing Yang
Chengdong Xu
Qingfeng Du
author_sort Jing Wu
collection DOAJ
description Abstract Background Cognitive impairment, hypertension and diabetes are prevalent chronic conditions in populations of older ages. Previous studies have shown that hypertension and diabetes are risk factors for the development of cognitive impairment. However, the impact of hypertension combined with diabetes (HD) and their cumulative effects on cognitive impairment remain unclear. We aimed to investigate whether HD influences development of cognitive impairment and whether the effect is cumulative. Methods A case–control study was conducted. From 40,103 subjects aged 60 years or older, enrolled from 28 representative communities of 9 provinces of China between January 2015 and December 2021 into the Prevention and Intervention on Neurodegenerative Disease for Elderly in China program using multi-stage stratified random sampling, individuals not meeting our propensity score matching criteria were excluded, and 13,252 individuals were finally selected for the study. Exposure factors included hypertension, diabetes and their comorbidity. Odds ratios (ORs) of exposure factors on cognitive impairment were measured using multiple logistic regression. Results We found significant impacts of hypertension, diabetes and their comorbidity on cognitive impairment occurrence. The OR values for dementia were 1.18 for individuals with hypertension only, 1.26 for those with diabetes only, and 1.53 for those with HD. Compared to participants without hypertension and diabetes, the OR values for mild cognitive impairment (MCI) were 1.11 for individuals with hypertension only, 1.32 for those with diabetes only, and 1.27 for those with HD. For subjects with HD longer than 5 years, the comorbidity significantly impacted on MCI and dementia, and the degree of impact increased with the duration of comorbidity. For hypertension, the influence of hypertension on dementia were most influential in middle-aged (45–64 years old) people. By contrast, the influence of diabetes on people younger than 45-year-old was most significant, with the middle-age group being the second most impacted subjects. Conclusions The elderly with HD have a heightened risk of developing cognitive impairment, particularly dementia, compared to those with either hypertension or diabetes alone. The study revealed a significant cumulative impact of HD on cognitive impairment.
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spelling doaj-art-cba6ac3b3d034144a2707d2bd5e3aedc2025-08-20T03:42:30ZengBMCAlzheimer’s Research & Therapy1758-91932025-05-0117111410.1186/s13195-025-01761-3Hypertension and diabetes on cognitive impairment: a case–control study in ChinaJing Wu0Xiangjun Yin1Weiqiang Ji2Yang Liu3Jing Tang4Han Zhang5Shige Qi6Jie Li7Li Lin8Xueqing Yang9Chengdong Xu10Qingfeng Du11National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and PreventionNational Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and PreventionHospital of Integrated Traditional Chinese and Western Medicine, Southern Medical UniversityNational Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and PreventionSchool of Traditional Chinese Medicine, Southern Medical UniversityNational Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and PreventionNational Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and PreventionSchool of Geography and Remote Sensing, Guangzhou UniversitySchool of Traditional Chinese Medicine, Southern Medical UniversityNational Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and PreventionState Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of SciencesGuangdong Basic Research Center of Excellence for Integrated Traditional and Western Medicine for Qingzhi DiseasesAbstract Background Cognitive impairment, hypertension and diabetes are prevalent chronic conditions in populations of older ages. Previous studies have shown that hypertension and diabetes are risk factors for the development of cognitive impairment. However, the impact of hypertension combined with diabetes (HD) and their cumulative effects on cognitive impairment remain unclear. We aimed to investigate whether HD influences development of cognitive impairment and whether the effect is cumulative. Methods A case–control study was conducted. From 40,103 subjects aged 60 years or older, enrolled from 28 representative communities of 9 provinces of China between January 2015 and December 2021 into the Prevention and Intervention on Neurodegenerative Disease for Elderly in China program using multi-stage stratified random sampling, individuals not meeting our propensity score matching criteria were excluded, and 13,252 individuals were finally selected for the study. Exposure factors included hypertension, diabetes and their comorbidity. Odds ratios (ORs) of exposure factors on cognitive impairment were measured using multiple logistic regression. Results We found significant impacts of hypertension, diabetes and their comorbidity on cognitive impairment occurrence. The OR values for dementia were 1.18 for individuals with hypertension only, 1.26 for those with diabetes only, and 1.53 for those with HD. Compared to participants without hypertension and diabetes, the OR values for mild cognitive impairment (MCI) were 1.11 for individuals with hypertension only, 1.32 for those with diabetes only, and 1.27 for those with HD. For subjects with HD longer than 5 years, the comorbidity significantly impacted on MCI and dementia, and the degree of impact increased with the duration of comorbidity. For hypertension, the influence of hypertension on dementia were most influential in middle-aged (45–64 years old) people. By contrast, the influence of diabetes on people younger than 45-year-old was most significant, with the middle-age group being the second most impacted subjects. Conclusions The elderly with HD have a heightened risk of developing cognitive impairment, particularly dementia, compared to those with either hypertension or diabetes alone. The study revealed a significant cumulative impact of HD on cognitive impairment.https://doi.org/10.1186/s13195-025-01761-3Cognitive impairmentHypertensionDiabetesElderlyCase–control study
spellingShingle Jing Wu
Xiangjun Yin
Weiqiang Ji
Yang Liu
Jing Tang
Han Zhang
Shige Qi
Jie Li
Li Lin
Xueqing Yang
Chengdong Xu
Qingfeng Du
Hypertension and diabetes on cognitive impairment: a case–control study in China
Alzheimer’s Research & Therapy
Cognitive impairment
Hypertension
Diabetes
Elderly
Case–control study
title Hypertension and diabetes on cognitive impairment: a case–control study in China
title_full Hypertension and diabetes on cognitive impairment: a case–control study in China
title_fullStr Hypertension and diabetes on cognitive impairment: a case–control study in China
title_full_unstemmed Hypertension and diabetes on cognitive impairment: a case–control study in China
title_short Hypertension and diabetes on cognitive impairment: a case–control study in China
title_sort hypertension and diabetes on cognitive impairment a case control study in china
topic Cognitive impairment
Hypertension
Diabetes
Elderly
Case–control study
url https://doi.org/10.1186/s13195-025-01761-3
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