Non-linear relationship of serum albumin-to-globulin ratio and cognitive function in American older people: a cross-sectional national health and nutrition examination survey 2011-2014 (NHANES) study

Front Public Health. 2024 Apr 26:12:1375379. doi: 10.3389/fpubh.2024.1375379. eCollection 2024.

Abstract

Background: Inflammation and liver function are associated with cognitive decline and dementia. Little is known about the serum albumin-to-globulin ratio on cognitive function.

Objective: The objective of this study was to investigate the association between albumin-to-globulin ratio and cognitive function among the American older people.

Methods: The public data available on the US National Health and Nutrition Examination Survey (NHANES) from 2011 to 2014 was used for this cross-sectional study. Participants aged ≥60 years completed the cognitive function assessments, including word learning and recall modules from the Consortium to Establish a Registry for Alzheimer's Disease (CERAD), the animal fluency (AF) test, and the digit symbol substitution test (DSST). A composite cognition score was calculated to evaluate global cognition. The univariate and multivariate linear regression analysis, curve fitting, a threshold effect, along with a subgroup analysis and interaction tests were conducted.

Results: Serum albumin-to-globulin ratio (per 0.1 unit) was positively associated DSST score (β = 0.36, 95% CI: 0.21, 0.51), AF score (β = 0.1, 95% CI: 0.04, 0.16) and global cognition score (β = 0.05, 95% CI: 0.02, 0.07), after being fully adjusted, while albumin-to-globulin ratio was not related to CERAD score (β = 0.05, 95% CI: -0.02, 0.12). A non-linear was observed in the dose-response relationship between albumin-to-globulin ratio and global cognition (P for non-linearity < 0.001). The subgroup analysis was overall stable, yet the interaction test was significant for age on global cognition (P for interaction = 0.036).

Conclusion: The findings of this cross-sectional study suggested a positive and non-linear association between albumin-to-globulin ratio and cognitive function in the American older people. Maintaining albumin-to-globulin ratio with an appropriate range may be one of the therapeutic strategies to limit the progression of cognitive decline for the older people.

Keywords: NHANES; aging; albumin-to-globulin ratio; cognition; cross-sectional study.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cognition* / physiology
  • Cognitive Dysfunction / blood
  • Cross-Sectional Studies
  • Female
  • Globulins / analysis
  • Humans
  • Male
  • Middle Aged
  • Nutrition Surveys*
  • Serum Albumin* / analysis
  • Serum Globulins / analysis
  • United States

Substances

  • Serum Albumin
  • Serum Globulins
  • Globulins

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by grants from Zhejiang Traditional Chinese Medicine Science and Technology Program [2023ZL055] and Medical Health Science and Technology Project of Zhejiang Provincial Health Commission [2022KY922].