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OBJECTIVES: To investigate how cardiometabolic‐inflammatory risk factors are related to cognition among older adults in India and the United States. DESIGN: The Longitudinal Aging Study in India–Diagnostic Assessment of Dementia (LASI‐DAD) and the Harmonized Cognitive Assessment Protocol of the Health and Retirement Study (HRS‐HCAP) in the United States conducted an in‐depth assessment of cognition, using protocols designed for international comparison. SETTING: Cognitive tests were conducted in hospital or household settings in India and in household settings in the United States. PARTICIPANTS: Respondents aged 60 years and older from LASI‐DAD (N = 1,865) and respondents aged 65 years and older from HRS‐HCAP (N = 2,111) who provided venous blood specimen. MEASUREMENTS: We used total composite scores from the common cognitive tests administered. Cardiovascular risk was indicated by systolic and diastolic blood pressure, pulse rate, pro‐B‐type natriuretic peptide (proBNP), and homocysteine. Metabolic risk was measured by body mass index, glycosylated hemoglobin (HbA1c), high‐density lipoprotein cholesterol, and lipoprotein (a) (only in India). Inflammatory risk was indicted by white blood cell count, C‐reactive protein, albumin, and uric acid (only in India). RESULTS: The distribution of both total cognition scores and of cardiometabolic risk factors differed significantly between India and the United States. In both countries, lower cognition was associated with older age, lower education, elevated homocysteine, elevated proBNP, and lower albumin levels. The associations between HbA1c levels and cognitive measures were statistically significant in both countries, but in the opposite direction, with a coefficient of 1.5 (P <.001) in India and −2.4 (P <.001) in the United States for one percentage increase in absolute HbA1c value. CONCLUSION: Cardiometabolic‐inflammatory biomarkers are associated with cognitive functional levels in each country, but the relationships may vary across countries. J Am Geriatr Soc 68:S36‐S44, 2020. [ABSTRACT FROM AUTHOR]

The Harmonized Diagnostic Assessment of Dementia for the Longitudinal Aging Study in India (LASI-DAD) is a nationally representative in-depth study of cognitive aging and dementia. We present a publicly available dataset of harmonized cognitive measures of 4,096 adults 60 years of age and older in India, collected across 18 states and union territories. Blood samples were obtained to carry out whole blood and serum-based assays. Results are included in a venous blood specimen datafile that can be linked to the Harmonized LASI-DAD dataset. A global screening array of 960 LASI-DAD respondents is also publicly available for download, in addition to neuroimaging data on 137 LASI-DAD participants. Altogether, these datasets provide comprehensive information on older adults in India that allow researchers to further understand risk factors associated with cognitive impairment and dementia., (© 2023. The Author(s).)