The association between waist-to-height ratio and cognitive function in older adults

ABSTRACT

Objectives

The waist-to-height ratio (WHtR) is a simple, practical, and effective tool used to assess central obesity. Despite its usefulness, few studies have investigated the association between WHtR and cognitive function among older adults in the United States. This study aims to investigate the associations between WHtR and cognitive function.

Methods

The study sample comprised adults who participated in the National Health and Nutrition Examination Survey (NHANES) between 2011 and 2014. WHtR was calculated from measured waist circumference and height. Cognitive function was assessed using the digit symbol substitution test. A weighted multiple linear regression analysis was performed to evaluate the association between WHtR and cognitive function, with smooth curve fitting applied to detect non-linearities.

Results

Our analysis included 1709 participants over the age of 65. After adjusting for potential confounders, WHtR was found to have a negative association with cognitive function (β = −36.91, 95% CI: −54.54 to −19.29, P < 0.001). Subgroup analyzes stratified by sex and race showed that the negative correlation of WHtR with cognitive function remained in both men and women, as well as in non-Hispanic white and other races. Among women, the association between WHtR and cognitive function followed an inverted U-shaped curve, with an inflection point of 0.68.

Conclusion

This study provides evidence of a negative association between WHtR and cognitive function in older adults. These findings suggest that in advanced age, central obesity may have negative implications for cognitive function.

KEYWORDS:

• Waist-to-height ratio
• cognitive function
• digit symbol substitution test
• NHANES

Acknowledgements

We would like to thank all the people involved in the National Health and Nutrition Examination Survey (NHANES). Authors’ contributions: Each author contributed substantially to the paper. Chuan Du and Huajuan Tang conceived the study hypothesis. Huajuan Tang and Qian Li performed data analysis and drafted the manuscript. Chuan Du revised it critically for important intellectual content, and supervised the writing of the manuscript. All authors approved the final version of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The original data utilized in this study can be accessed from publicly available databases (https://www.cdc.gov/nchs/nhanes/index.htm). Further inquiries can be directed to contact the corresponding author.

Additional information

Funding

This work was funded by Scientific Research Project of Health Commission of Sichuan Province (Grant ref: 20PJ229).

Notes on contributors

Huajuan Tang

Huajuan Tang is a physician of 363 Hospital in the department of neurology. Her research focus is on risk factor and mechanism of cognitive impairment in older adults.

Qian Li

Qian Li is a chief physician, currently works at 363 Hospital. Alzheimer's disease and epilepsy are her primary areas of specialization, and her research interests center on the prevention and treatment of cognitive impairment.

Chuan Du

Chuan Du is an attending physician, currently pursuing a PhD functional neurosurgery at Tianjin Medical University. His research work involves studying the prevention and minimally invasive treatment of degenerative neurological diseases.