Association between continuous metabolic syndrome score and incident dementia: a longitudinal study of middle-aged and older Chinese adults.

Authors

Ling Lin, Hua Liu, Dan Long, Chaofeng Fan

Published in

BMC neurology. Jul 03, 2026. Epub Jul 03, 2026.

Abstract

While metabolic syndrome (MetS) is a well-established driver of cognitive decline, conventional dichotomous diagnostic criteria fail to capture the cumulative and synergistic allostatic load of metabolic dysfunction. We investigated the longitudinal association between an age- and sex-standardized continuous MetS severity score and risk of incident dementia in a nationally Chinese cohort.
This prospective analysis utilized data from the China Health and Retirement Longitudinal Study. A continuous MetS score was calculated at baseline integrating waist circumference, triglycerides, high-density lipoprotein cholesterol, mean arterial pressure, and fasting blood glucose via validated linear models, and then quartiled (lowest quartile as reference). Incident dementia was ascertained during the Wave 4 follow-up using a rigorous, multidimensional diagnostic protocol. The dose-response relationship was evaluated using restricted cubic splines (RCS) and logistic regression.
Among 4,920 dementia-free participants at baseline, 667 (13.56%) developed dementia over the follow-up. RCS modeling revealed a significant, linear dose-response association between increasing MetS scores and dementia risk. Each 1-SD increment in the MetS score was independently associated with a 12% higher risk of dementia (OR = 1.12, 95% CI: 1.01-1.24). Participants in the highest quartile group faced a 48% increased risk compared to those in the lowest quartile (OR = 1.48, 95% CI: 1.07-2.04). This risk amplification was uniquely pronounced among non-obese individuals (BMI < 24 kg/m²; P-interaction = 0.378).
An elevated continuous MetS score is a robust, independent predictor of incident dementia in middle-aged and older adults. Transitioning from binary criteria to a continuous MetS metric provides a nuanced, dose-dependent assessment of dementia risk.

PMID:
42399845
Bibliographic data and abstract were imported from PubMed on 04 Jul 2026.

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