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Objective <p>This study aimed to investigate the influence of different obesity–metabolic syndrome (MetS) statuses on mild cognitive impairment (MCI) and to explore the modifying roles of related factors.</p> Methods <p>Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS, 2011–2015) and a real-world cohort (RWC). Binary logistic regression and restricted cubic spline models were used to examine the associations between obesity, MetS, and MCI, adjusting for covariates. In the RWC, the effects of obesity–metabolic phenotypes on cognitive function were further explored using structural magnetic resonance imaging (MRI) to evaluate brain atrophy.</p> Results <p>A total of 6079 participants from CHARLS and 522 from the RWC were included. Each additional MetS component increased the risk of MCI in females aged &lt; 60 and 60–70&#xa0;years. Low high-density lipoprotein (HDL) levels in older males negatively affected cognition, and elevated fasting glucose was significantly associated with poorer cognitive performance. Metabolically unhealthy non-obesity (MUNO) and metabolically unhealthy obesity (MUO) were associated with higher MCI risk both in males and females, while metabolically healthy obesity (MHO) in males aged 60–70&#xa0;years was also linked to increased risk. RWC further revealed that MHO, MUNO, and MUO groups exhibited varying degrees of brain atrophy compared with healthy controls.</p> Conclusion <p>Findings from both cohorts suggest that obesity and metabolic health jointly influence cognitive impairment risk. Structural MRI results highlight that metabolic dysregulation may exacerbate obesity-related neurodegeneration.</p>

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Association of mild cognitive impairment and obesity–metabolic status in middle-aged and elderly adults: a nationwide prospective cohort study

  • 期刊论文

  • 发表日期：

    2026年1月31日

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  • Weijie Zhai,
  • Anguo Zhao,
  • Jun Zhang

摘要

Objective

This study aimed to investigate the influence of different obesity–metabolic syndrome (MetS) statuses on mild cognitive impairment (MCI) and to explore the modifying roles of related factors.

Methods

Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS, 2011–2015) and a real-world cohort (RWC). Binary logistic regression and restricted cubic spline models were used to examine the associations between obesity, MetS, and MCI, adjusting for covariates. In the RWC, the effects of obesity–metabolic phenotypes on cognitive function were further explored using structural magnetic resonance imaging (MRI) to evaluate brain atrophy.

Results

A total of 6079 participants from CHARLS and 522 from the RWC were included. Each additional MetS component increased the risk of MCI in females aged < 60 and 60–70 years. Low high-density lipoprotein (HDL) levels in older males negatively affected cognition, and elevated fasting glucose was significantly associated with poorer cognitive performance. Metabolically unhealthy non-obesity (MUNO) and metabolically unhealthy obesity (MUO) were associated with higher MCI risk both in males and females, while metabolically healthy obesity (MHO) in males aged 60–70 years was also linked to increased risk. RWC further revealed that MHO, MUNO, and MUO groups exhibited varying degrees of brain atrophy compared with healthy controls.

Conclusion

Findings from both cohorts suggest that obesity and metabolic health jointly influence cognitive impairment risk. Structural MRI results highlight that metabolic dysregulation may exacerbate obesity-related neurodegeneration.