THE METABOLIC-COGNITIVE PATHWAY IN SCHIZOPHRENIA: EXAMINING FASTING GLUCOSE, LIPIDS, AND BLOOD PRESSURE AS PREDICTORS OF COGNITIVE IMPAIRMENT AND DEMENTIA RISK

Background

Schizophrenia is increasingly recognized as a systemic disorder characterized by pervasive metabolic, vascular, and bioenergetic abnormalities. Cognitive impairment is a core and often treatment-refractory feature of schizophrenia and a major determinant of functional outcome. Individuals with schizophrenia also display high rates of metabolic syndrome, type 2 diabetes, dyslipidemia, and hypertension, and have an increased risk of dementia. While peripheral metabolic abnormalities are well documented, their association with cognitive impairment in schizophrenia are not as well understood.

Objective

To examine associations between metabolic markers (glucose metabolism, lipids, blood pressure, and anthropometric measures) and cognitive performance across domains in individuals with schizophrenia compared with healthy controls.

Methods

This study examines comprehensive metabolic profiles in 120 participants (60 with schizophrenia, 60 healthy controls) aged 18-45. Metabolic assessments include fasting blood glucose, fasting insulin, complete lipid panel (total cholesterol, LDL, HDL, triglycerides), and blood pressure measurements. Cognitive function is evaluated using the MATRICS Consensus Cognitive Battery (MCCB) to assess working memory, attention, verbal learning, and visual learning. Anthropometric measures (BMI, waist circumference) are also collected. Multiple linear regression analyses will examine the associations between metabolic parameters and cognitive outcomes, while controlling for age, sex, education, antipsychotic medication (as measured by chlorpromazine equivalents), and smoking status. Expected

Results

We hypothesize that higher insulin resistance (fasting insulin/HOMA-IR), more atherogenic lipid profiles (higher triglycerides/lower HDL), elevated blood pressure, and higher adiposity will be associated with poorer cognition, with stronger effects in participants with schizophrenia versus the control group. Preliminary analyses indicate significant inverse correlations between fasting glucose levels and insulin resistance and MCCB total scores. Full statistical analyses in progress. Expected Conclusion and significance: Metabolic dysregulation is a potentially modifiable risk factor for cognitive impairment in schizophrenia. Targeting metabolic and vascular abnormalities may represent a critical strategy for preserving cognition and reducing dementia risk in this population.