Association of a novel nutritional index with cognitive impairment in middle-aged and elderly Chinese adults: a cross-sectional analysis from the China Health and Retirement Longitudinal Study

Abstract

Purpose: The triglyceride-cholesterol-body weight index (TCBI), a novel and easily computable nutritional index, incorporates serum triglyceride (TG), total cholesterol (TC), and body weight (BW). This study explored the association between TCBI and cognitive impairment in middle-aged and elderly Chinese populations.

Patients and methods: This cross-sectional study employed data from the China Health and Retirement Longitudinal Study (CHARLS) baseline survey, including 7,145 participants. TCBI was calculated as TG (mg/dL) × TC (mg/dL) × BW (kg)/1,000. Cognitive function was assessed based on mental status and episodic memory, with a total score below 11 indicating cognitive impairment. The relationship between TCBI and cognitive impairment was examined using multiple logistic regression, smooth curve fitting, and subgroup analyses.

Results: After full adjustment, each 1-unit increase in log-transformed TCBI (Lg TCBI) was associated with a 29.7% reduction in cognitive impairment risk [odds ratio (OR) = 0.703, 95% confidence interval (CI): 0.529-0.933; p = 0.015]. When Lg TCBI was categorized into quartiles, the Q2, Q3, and Q4 groups exhibited a reduced risk of cognitive impairment by 19.9, 16.3, and 22.9%, respectively (p for trend = 0.043), compared to the Q1 group. Smooth curve fitting revealed a consistent decrease in cognitive impairment risk with higher Lg TCBI levels. Subgroup analysis indicated that the association was stronger among participants aged ≥60 years (OR = 0.655, 95% CI: 0.438-0.979), non-current drinkers (OR = 0.643, 95% CI: 0.451-0.917), and those who engaged in socializing (OR = 0.568, 95% CI: 0.371-0.871).

Conclusion: TCBI was significantly and negatively associated with cognitive impairment in Chinese middle-aged and elderly individuals, with the effect more pronounced in those aged ≥60 years, non-current drinkers, and socially active participants.

Keywords: CHARLS; TCBI; cognitive impairment; cross-sectional study; nutritional index.

Figure 1

Participant selection process flowchart.

Figure 2

The association between TCBI and cognitive impairment. The relationship was detected after adjusting for age, sex, residence, education, marital status, retirement, current smoking, current drinking, socializing, hypertension, diabetes, dyslipidemia, stroke, depression symptoms, SBP, DBP, BMI, FPG, LDL-C, HDL-C, and hsCRP.