Association Between Triglycerides and Incident Cognitive Impairment in Black and White Adults in the Reasons for Geographic and Racial Differences in Stroke Study

BACKGROUND: Elevated nonfasting triglycerides were associated with non‐Alzheimer dementia in a recent study. However, this study neither evaluated the association of fasting triglycerides with incident cognitive impairment (ICI) nor adjusted for high‐density lipoprotein cholesterol or hs‐CRP (high‐sensitivity C‐reactive protein), known risk markers for ICI and dementia. METHODS AND RESULTS: We examined the association between fasting triglycerides and ICI among 16 170 participants in the REGARDS (Reasons for Geographic and Racial Differences in Stroke) study without cognitive impairment or a history of stroke at baseline in 2003 to 2007 and who had no stroke events during follow‐up through September 2018. Overall, 1151 participants developed ICI during the median follow‐up of 9.6 years. The relative risk for ICI associated with fasting triglycerides of ≥150 mg/dL versus <100 mg/dL including adjustment for age and geographic region of residence was 1.59 (95% CI, 1.20–2.11) among White women and 1.27 (95% CI, 1.00–1.62) among Black women. After multivariable adjustment, including adjustment for high‐density lipoprotein cholesterol and hs‐CRP, the relative risk for ICI associated with fasting triglycerides ≥150 mg/dL versus <100 mg/dL was 1.50 (95% CI, 1.09–2.06) among White women and 1.21 (95% CI, 0.93–1.57) among Black women. There was no evidence of an association between triglycerides and ICI among White or Black men. CONCLUSIONS: Elevated fasting triglycerides were associated with ICI in White women after full adjustment including high‐density lipoprotein cholesterol and hs‐CRP. The current results suggest that the association between triglycerides and ICI is stronger in women than men.