Key result
Higher fasting glucose is linked to lower cognitive scores, whereas higher cholesterol correlates with better performance.
Why the study?
Are fasting blood glucose and total cholesterol concentrations associated with cognitive performance (ACE-III and MMSE scores) in older primary care patients?
Cross-Sectional (n=137)
No
Are fasting blood glucose and total cholesterol concentrations associated with cognitive performance (ACE-III and MMSE scores) in older primary care patients?
Answers are grounded in this paper and cite their sources.
In primary care patients aged 50–76, higher fasting glucose correlates with poorer cognitive performance and higher total cholesterol correlates with slightly better performance on the ACE-III, whereas the standard MMSE fails to detect these subtle metabolic associations.
Objectives: This cross-sectional study aimed to evaluate the associations between fundamental metabolic markers, specifically fasting glucose and total cholesterol, and cognitive performance in a primary care population, continuing previous analyses focused on subclinical vascular parameters. Methods: The study included 137 primary care patients who completed neuropsychological assessments (Addenbrooke’s Cognitive Examination-III (ACE-III) and Mini-Mental State Examination (MMSE)) and a clinical interview. Fasting glucose and total cholesterol levels were extracted from their medical records. Results: Based on the MMSE, 26 participants (19.0%) had mild cognitive impairment (MCI), and 8 (5.8%) had neurocognitive disorders. Univariate regression analysis revealed that fasting glucose was significantly and inversely associated with the total ACE-III score (B = 0.277; 95% CI: −0.441 to −0.113; p = 0.001) and the M-ACE subscale score (B = 0.175; 95% CI: −0.342 to −0.008; p = 0.046). Conversely, total cholesterol showed a positive association with both the overall ACE-III score (B = 0.173; 95% CI: 0.006 to 0.340; p = 0.046) and the M-ACE score (B = 0.219; 95% CI: 0.053 to 0.385; p = 0.011). A potential clinical paradox was observed, as among patients with established cardiovascular disease, lower total cholesterol (177.39 vs. 201.58 mg/dL, p = 0.047) co-occurred with poorer cognitive outcomes (mean ACE-III: 81.47 vs. 87.62, p = 0.003), possibly reflecting a confounding effect of statin therapy. Standard MMSE scores did not correlate significantly with any evaluated metabolic parameters. Conclusions: Fasting glucose and total cholesterol are cross-sectionally associated with cognitive performance in this primary care cohort, whereas standard MMSE scores did not exhibit significant metabolic correlations. Given the exploratory, cross-sectional design, these findings are strictly hypothesis-generating and do not establish clinical screening utility or causality. The disparate patterns of association between the ACE-III and MMSE suggest that these screening tools may capture metabolism-related cognitive variations differently, highlighting the need for prospective longitudinal research.
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Gostyńska et al. (2026) conducted a cross-sectional in Cognitive performance and mild cognitive impairment in primary care patients (n=137). Fasting blood glucose and total cholesterol levels was evaluated on Total Addenbrooke’s Cognitive Examination-III (ACE-III) score (β -0.28 for fasting glucose; β 0.17 for total cholesterol, 95% CI -0.44 to -0.11, p=0.001). Fasting glucose was inversely associated with total ACE-III cognitive scores, whereas total cholesterol showed a positive association.
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