Triglyceride-glucose index as a metabolic biomarker in elderly patients with vascular cognitive impairment

This study aimed to investigate the clinical significance of the triglyceride–glucose (TyG) index in elderly patients with vascular cognitive impairment (VCI). A total of 102 elderly patients with VCI admitted to the Department of Neurology, Rudong People's Hospital, between May 2023 and May 2024 were retrospectively analyzed. Based on the severity of cognitive impairment, patients were categorized into a vascular mild cognitive impairment (VMCI) group (n = 65) and a vascular dementia (VD) group (n = 37). Additionally, 50 age-matched healthy individuals during the same period served as the control group. The TyG index, Montreal Cognitive Assessment (MoCA) score, and Activity of Daily Living (ADL) score were compared among the three groups. Correlations between the TyG index and MoCA and ADL scores were examined using Spearman correlation analysis, and the diagnostic value of the TyG index for VCI was evaluated using receiver operating characteristic (ROC) curve analysis. Significant differences were observed in TyG index, MoCA, and ADL scores among the three groups (P < 0.05). The VD group exhibited a significantly higher TyG index and lower MoCA and ADL scores compared with the VMCI and control groups (P < 0.05). The TyG index was negatively correlated with MoCA and ADL scores in both the VD group (r = −0.542, −0.625; P < 0.05) and the VMCI group (r = −0.568, −0.607; P < 0.05). ROC analysis showed that the area under the curve (AUC), sensitivity, and specificity of the TyG index for diagnosing VD were 0.949 (P < 0.05), 94.6%, and 86.1%, respectively; for diagnosing VMCI, the corresponding values were 0.822 (P < 0.05), 72.3%, and 76.0%. The TyG index is significantly elevated in elderly patients with VCI and is negatively correlated with cognitive and functional performance. It may serve as a reliable biomarker for assessing the severity and progression of vascular cognitive impairment.