Coronary heart disease combined with diabetes increases the risk of cognitive impairment ： a cross-sectional study of the rural population in Xi'an

Objective To investigate the correlation between coronary heart disease (CHD) and cognitive impairment in rural populations aged 40 and above.Methods From October 2014 to March 2015, all residents aged 40 and above from two villages in Huyi District, Xi'an, were selected as study subjects.Information regarding their demographics, lifestyle habits,medical history, family history, physical examinations, and biochemical tests was collected.The participants were categorized into those with and without the history of CHD.Cognitive function was assessed using the Mini-Mental State Examination (MMSE), with scores below the cutoff (illiteracy ≤ 17; primary school ≤ 20; junior high school and above ≤ 24) defined as cognitive impairment. Chi-square test was used to compare the prevalence of cognitive impairment between the CHD and non-CHD groups. Multivariate Logistic regression was employed to adjust for confounding factors in analyzing the relationship between CHD and cognitive impairment.Results A total of 1833 subjects were included in the analysis, comprising 735males (40.1%) and 57 individuals withCHD (3.1%).Among them, 234 participants (13.3%)met the criteria for cognitive impairment. Univariate analysis showed a higher prevalence of cognitive impairment in the CHD group compared to the non-CHD group (24.6%vs.12.9%, P=0.016). Unadjusted binary Logistic regression analysis indicated a positive correlation between CHD and cognitive impairment (OR=2.199, 95%CI: 1.185-4.084, P=0.013). However, after adjusting for confounding factors such as gender, age, education level, hypertension, diabetes, dyslipidemia, stroke history and BMI, the association between CHD and cognitive impairment was not statistically significant (OR=1.265, 95%CI ：0.656-2.441, P=0.483).In the stratified analysis, among diabetic patients, CHD was significantly associated with a high risk of cognitive impairment (OR=4.191, 95%CI ：1.464-12.000, P=0.008). The prevalence of cognitive impairment significantly increased in patients with CHD combined with diabetes (OR= 4.712, 95%CI ：1.651-13.449, P=0.004). Conclusion This study did not establish a direct association between CHD and cognitive impairment. However, this study suggests that the presence of CHD and diabetesmellitus is significantly associated with an increased risk of cognitive impairment. Future prospective studies with larger sample sizes should be conducted to further confirm the relationship between the two.