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Association between the atherogenic index of plasma and cognitive impairment
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  • Published: 22 February 2026

Association between the atherogenic index of plasma and cognitive impairment

  • Yiying Li2 na1,
  • Yuke Zhang2 na1,
  • Yu Zhang1,2 na1,
  • Xinyu Yang2 &
  • …
  • Yuehong Ni1 

Scientific Reports , Article number:  (2026) Cite this article

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We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply.

Subjects

  • Cardiology
  • Diseases
  • Health care
  • Medical research
  • Neurology
  • Neuroscience
  • Risk factors

Abstract

The Atherogenic Index of Plasma (AIP), a burgeoning composite lipid marker that reflects overall lipid balance, has an incompletely understood longitudinal relationship with cognitive impairment. This study conducted a systematic investigation into the long-term, nonlinear association between AIP and the risk of cognitive impairment among middle-aged and older adults, utilizing longitudinal data from the China Health and Retirement Longitudinal Study (CHARLS) spanning from 2011 to 2020. The study encompassed 2971 participants who were free from cognitive impairment at baseline and were followed for a period of up to 10 years. The cumulative incidence of new-onset cognitive impairment was found to be 40.46% in men and 54.45% in women. A multivariable-adjusted Cox regression analysis revealed that an elevated AIP, particularly within the 25th to 75th percentile range, was an independent risk factor for cognitive impairment (P < 0.05). Further analysis employing restricted cubic splines (RCS) uncovered a significant inverted U-shaped nonlinear association between AIP and cognitive impairment risk (P-nonlinear < 0.001), with a notably increased risk within the AIP range of 0.205 to 0.423. Subgroup analyses, stratified by sex, age, educational level, and BMI, showed consistent trends across various demographic groups. This study suggests that AIP, as a straightforward composite lipid marker, exhibits a significant nonlinear association with the risk of cognitive impairment in middle-aged and older adults. Monitoring AIP levels could assist in the early identification of individuals at high risk, and targeted interventions within specific AIP ranges, such as 0.205–0.423, could have significant public health implications, offering a new potential target for preventive strategies against cognitive decline.

Data availability

The datasets supporting the conclusions of this article are available in the website of China Health and Retirement Longitudinal Study (https://charls.pku.edu.cn/).

Abbreviations

CHARLS:

China health and retirement longitudinal study

AIP:

Atherogenic index of plasma

TG:

Triglycerides

RCS:

Restricted cubic spline model

CDC:

Centers for disease control and prevention

MMSE:

Mini-mental state examination

BMI:

Body mass index

CAS:

carotid atherosclerosis

VCI:

Vascular cognitive impairment

MCT:

Medium-chain triglyceride

PUDG:

Long-chain polyunsaturated fatty acid-containing triglycerides

AD:

Alzheimer’s disease

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Acknowledgements

This article uses data from the China Health and Retirement Longitudinal Study (CHARLS). We thank the CHARLS research and field team and every respondent in the study for their contributions.

Funding

None.

Author information

Author notes

  1. These authors contributed equally: Yiying Li, Yuke Zhang and Yu Zhang.

Authors and Affiliations

  1. Huzhou Central Hospital, Affiliated Central Hospital of Huzhou University, Huzhou, Zhejiang, China

    Yu Zhang & Yuehong Ni

  2. College of Medical Science, Huzhou University, Huzhou, Zhejiang, China

    Yiying Li, Yuke Zhang, Yu Zhang & Xinyu Yang

Authors
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Contributions

Yiyng Li, Yu Zhang: Study design and data acquisition; Xinyu Yang: data analysis; Yuke Zhang, Yu Zhang and Xinyu Yang: manuscript editing; Yiying Li and Yuehong Ni: manuscript review. All authors approved the final version of the study.

Corresponding author

Correspondence to Yuehong Ni.

Ethics declarations

Ethics approval and consent to participate

This study was performed in line with the principles of the Declaration of Helsinki and all participants signed informed consents before participation. Approval was granted by the Ethical Review Committee at Peking University (IRB00001052-11015).

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The authors declare no competing interests.

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Li, Y., Zhang, Y., Zhang, Y. et al. Association between the atherogenic index of plasma and cognitive impairment. Sci Rep (2026). https://doi.org/10.1038/s41598-026-41335-3

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  • Received: 05 November 2025

  • Accepted: 19 February 2026

  • Published: 22 February 2026

  • DOI: https://doi.org/10.1038/s41598-026-41335-3

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Keywords

  • Atherogenic index of plasma
  • Cognitive impairment
  • CHARLS
  • Restricted cubic spline
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