Increased 1H-NMR metabolomics-based health score associates with declined cognitive performance and functional independence in older adults at risk of cardiovascular disease

BackgroundThe 1-HMR metabolomics-based MetaboHealth score, comprised of 14 serum metabolic markers, associates with disease-specific mortality, but it is unclear whether the score also reflects cognitive changes and functional impairment. ObjectivesAssess the associations between the MetaboHealth score with cognitive and daily functioning, and cognitive and functional decline in older people at increased cardiovascular risk. Methods5292 older people free of dementia at baseline with mean age 75.3 years (standard deviation=3.4) from the Prospective Study of Pravastatin in the Elderly (PROSPER). MetaboHealth score was measured at baseline, and cognitive function and functional independence were measured at baseline and every 3 months during up to 2.5-years follow-up. Cognitive function was assessed using the Stroop test (selective attention), the Letter Digit Coding test (LDCT) (processing speed), and the two versions of the Picture Learning test (delayed and immediate; memory). Two tests of functional independence were used: Barthel Index (BI) and instrumental activities at daily living (IADL). ResultsA higher MetaboHealth score was associated with worse cognitive function (in all domains) and with worse functional independence. For example, after full adjustments, a 1-SD higher MetaboHealth score was associated with 9.02 (95%CI 7.29, 10.75) seconds slower performance on the Stroop test and 2.79 (-3.26,-2.21) less digits coded on the LDCT. During follow-up, 1-SD higher MetaboHealth score was associated with an additional decline of 0.53 (0.23,0.83) seconds on the Stroop test and -0.08 (-0.11,-0.06) points on the IADL. ConclusionMetabolic disturbance, as reflected by an increased metabolomics-based health score, may mark future cognitive and functional decline.