Apolipoprotein Mediation in the Relationship Between Weight-Adjusted Waist Index and Cognitive Decline

Abstract Background: The weight-adjusted waist index (WWI) is an innovative measure of obesity. This study aimed to investigate the relationship between WWI and cognitive function in Chinese population. Methods: Using the China Health and Nutrition Survey (CHNS) database 1989-2011 dataset, cross-sectional data from 7838 participants were analyzed. The association between WWI and cognitive impairment was investigated by multiple regression analysis and subgroup analysis. In addition, restricted cubic spline (RCS) was applied to explore nonlinear relationships, and mediation analysis was carried out to assess whether Apolipoprotein influenced these relationships. Results: The research involved 7838 participants aged 55 years and older. The fully adjusted model revealed a positive and significant association between WWI and low cognitive performance [2.55(2.19,2.96)], implying that individuals with higher WWI have a higher likelihood of cognitive impairment. Restricted Cubic Spline (RCS) analyses showed a nonlinear relationship between WWI and and low cognition. Subgroup analyses and interaction tests confirmed the robustness of this positive correlation in different population settings (all P for interaction > 0.05). Mediation revealed that ApoA and ApoB may be mediators between WWI and cognitive impairment. Conclusion: A higher WWI was associated with a higher incidence of cognitive impairment. The results of this study highlight the value of the WWI in dementia prevention and managementin Chinese population.