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ORIGINAL RESEARCH article

Front. Nutr.

Sec. Nutrition, Psychology and Brain Health

Volume 12 - 2025 | doi: 10.3389/fnut.2025.1601541

The association between weight-adjusted-waist index and cognitive function: The cross-sectional and longitudinal evidence from CHARLS

Provisionally accepted
Sifan  QianSifan Qian*Qiuqing  WenQiuqing WenDi  JiangDi JiangShiliang  WangShiliang Wangxuqiang  huxuqiang hu
  • Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, huzhou, China

The final, formatted version of the article will be published soon.

Objective: Weight-adjusted waist index (WWI), a novel indicator of abdominal obesity that reflects body compositional changes due to aging, shows superiority in predicting obesity-related health risks. The present study aimed to investigate the cross-sectional and longitudinal association between WWI and cognitive function in the Chinese middle-aged and older population. Methods: A total of 8822 individuals were included in cross-sectional analyses, of whom 7697 had longitudinal data. The baseline WWI was calculated as waist circumference divided by the square root of body weight. Cognitive scores were assessed at baseline and every 2 to 3 years during follow-up. The primary outcome was cognitive z-scores. Linear regression and generalized estimating equation models were used to assess the cross-sectional association of WWI with cognitive function and its longitudinal association with cognitive decline, respectively. Results: Higher WWI was associated with lower baseline global cognitive score (β=-0.218 per unit increase; 95% CI: -0.333 to -0.103). Longitudinally, there was a significant association between WWI and accelerated global cognitive decline (β=-0.008 per unit increase; 95% CI: -0.013 to -0.003). However, higher body mass index was associated with slower cognitive decline, whereas waist circumference showed no significant association with cognitive decline. Conclusion: Higher baseline WWI levels were independently associated with an increased risk of subsequent cognitive decline, indicating WWI may be a potential obesity indicator for identifying poor cognitive performance among middle-aged and older adults.

Keywords: Weight-adjusted waist index, Obesity, cognitive decline, risk factor, Middle-aged and older adults

Received: 28 Mar 2025; Accepted: 15 Oct 2025.

Copyright: © 2025 Qian, Wen, Jiang, Wang and hu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Sifan Qian, 13757250673@163.com

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