Progression of Cardio-Kidney-Metabolic Syndrome Tied to Increased Cognitive Impairment Risk: CHARLS Study

CKM syndrome represents a broad cluster of interconnected health conditions, including diabetes, obesity, cardiovascular disease, and chronic kidney disease. While the link between these individual conditions and cognitive decline has been previously recognized, the cumulative impact of CKM syndrome as a whole on cognitive outcomes remained uncertain.

The team conducted a longitudinal observational study using data from the China Health and Retirement Longitudinal Study (CHARLS), spanning the period from 2011 to 2018. A total of 8,833 participants were assessed to examine the relationship between baseline CKM stages and cognitive impairment. An additional subset of 4,230 individuals was analyzed to evaluate how changes in the CKM stage over time (classified as improved, stable, or progressed) influenced cognitive outcomes.

Participants’ CKM status was categorized into five progressive stages based on American Heart Association criteria. The study employed logistic regression models to assess the risks associated with each stage and the transitions between stages.

The following were the key findings of the study:

• Individuals with higher baseline CKM stages had significantly greater odds of developing cognitive impairment.
• Compared to those with no CKM syndrome (stage 0), the adjusted odds ratios for cognitive impairment were 1.74 for stage 1, 2.05 for stage 2, 2.09 for stage 3, and 3.91 for stage 4.
• The increased risk of cognitive impairment was especially notable among men and older adults.
• Participants whose CKM stage worsened over time faced a 61% higher risk of cognitive impairment (aOR 1.61).
• Participants who showed improvements in CKM status exhibited a positive trend toward reduced cognitive risk (aOR 0.44), although this finding was not statistically definitive.

These findings highlight the crucial role of both early detection and proactive management of CKM syndrome in preserving cognitive health. The study authors emphasized that progression to advanced CKM stages is closely tied to cognitive decline and that reversing or stabilizing CKM status may help mitigate this risk.

The authors concluded, "The study highlights the need for clinicians to monitor and address CKM syndrome comprehensively—not only to prevent cardiovascular or kidney complications but also to safeguard cognitive function in aging populations."

Reference:

Zhu, Y., Wang, X., Wang, K. et al. Association between baseline cardio-kidney-metabolic syndrome, its transition and cognitive impairment: result from CHARLS study. Diabetol Metab Syndr 17, 211 (2025). https://doi.org/10.1186/s13098-025-01779-5