Abstract: SA-PO0484
Cardiovascular-Kidney-Metabolic Syndrome and Joint Cognitive-Gait Trajectories Among Older Adults: Health ABC Findings
Session Information
- CKM: Clinical - Screening, Population Management, Care Disparities, and Patient-Centered Outcomes
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Cardiovascular-Kidney-Metabolic Health
- 602 Cardiovascular-Kidney-Metabolic Health: Clinical
Authors
- Shrestha, Aman, University of Maryland Baltimore School of Medicine, Baltimore, Maryland, United States
- Shardell, Michelle, University of Maryland Baltimore School of Medicine, Baltimore, Maryland, United States
- Chen, Chixiang, University of Maryland Baltimore School of Medicine, Baltimore, Maryland, United States
- Ginsberg, Charles, University of California San Diego, La Jolla, California, United States
- Miller, Lindsay M., University of California San Diego, La Jolla, California, United States
- Seliger, Stephen L., University of Maryland Baltimore School of Medicine, Baltimore, Maryland, United States
- Tian, Qu, National Institute on Aging Intramural Research Program, Baltimore, Maryland, United States
- Ahmad, Anam, University of Maryland Baltimore School of Medicine, Baltimore, Maryland, United States
- Simonsick, Eleanor M., National Institute on Aging Intramural Research Program, Baltimore, Maryland, United States
- Cawthon, Peggy M., University of California San Francisco, San Francisco, California, United States
Background
Cardiovascular-kidney-metabolic syndrome (CKM) accelerates aging across multiple organ systems, but its impact on functional decline in older adults is unknown.
Methods
We examined baseline CKM stage with dual trajectory groups (DTG) of cognitive-physical performances among 1,902 Health Aging, and Body Composition Study participants (53% women; 26% Black) with intact baseline 20m usual gait speed (≥0.8m/s) and cognition (Teng Modified Mini Mental State [3MS]≥90). CKM was staged using the American Heart Association framework as Stage 1 (excess/dysfunctional adiposity; n=105), Stage 2 (metabolic risk factors or chronic kidney disease [CKD]; n=704), Stage 3 (subclinical cardiovascular disease [CVD] or very high-risk CKD; n=468), or Stage 4 (clinical CVD with Stage 1–3 factors; n=472). DTGs (years 3–10) yielded 3 groups: DTG1 (n=660), high, stable cognitive-gait performance; DTG2 (n=744), high cognition, declining gait speed; and DTG3 (n=498), low baseline performance with steep dual decline. We fit multinomial regression models (ref=Stage 0–1) with full adjustment for demographics (study site, sex, race, education and marital status), and alcohol intake, self-rated health, apolipoprotein ε4, depressive symptoms, baseline gait speed and baseline 3MS.
Results
Higher CKM stage was associated with greater odds of dual cognitive-gait decline. Compared with Stage 0–1, Stages 3 & 4 had higher odds of DTG2 (Stage 3 odds ratio [OR]=2.71, 95% confidence interval [CI]=1.55–4.72; Stage 4 OR=2.35, CI=1.34–4.12) and DTG3 (Stage 3 OR=3.20, CI=1.64–6.24; Stage 4 OR=3.74, CI=1.93–7.28) versus DTG1. Stage 2 only had higher odds of DTG2 (OR=1.71, CI=1.02–2.86).
Conclusion
Among initially healthy community-dwelling older adults, advanced CKM stage (3 & 4) was associated with a higher burden of both physical-only and dual cognitive-physical decline, suggesting a potential role for CKM staging in flagging older adults for closer functional monitoring.
Cardiovascular-kidney-metabolic syndrome (CKM) and dual cognitive-gait trajectories
| Model | N | CKM Stage (ref=Stage 0-1) | DTG 2 vs 1 | DTG 3 vs 1 |
| OR (95%CI), p-value | OR (95%CI), p-value | |||
| Adjusted for demographics | 1664 | Stage 2 | 1.75 (1.13 to 2.72), p=0.012 | 1.33 (0.78 to 2.27), p=0.30 |
| Stage 3 | 3.03 (1.89 to 4.84), p<.001 | 3.50 (2.02 to 6.08), p<.001 | ||
| Stage 4 | 3.45 (2.14 to 5.55), p<.001 | 5.36 (3.09 to 9.29), p<.001 | ||
| Full adjustment | 1567 | Stage 2 | 1.71 (1.02 to 2.86), p=0.041 | 1.44 (0.76 to 2.73), p=0.27 |
| Stage 3 | 2.71 (1.55 to 4.72), p<.001 | 3.20 (1.64 to 6.24), p<.001 | ||
| Stage 4 | 2.35 (1.34 to 4.12), p=0.003 | 3.74 (1.93 to 7.28), p<.001 |
Note. DTG=dual trajectory groups of cognition (Teng Modified Mini-Mental State [3MS]) and 20m usual gait speed
Funding
- Other NIH Support