Journal Article

Longitudinal associations between cardiovascular-kidney-metabolic syndrome and sensory impairments in Chinese middle-aged and older adults: a weighted marginal structural model analysis

Wu, Jing, Zhang, Qi, Zhou, Shaofeng, Ruan, Shiwei, Ruan, Xinglin, Lin, Jianlin

2026

Overview

Background Sensory impairments significantly contribute to functional decline in aging populations, yet their relationship with the newly defined cardiovascular-kidney-metabolic (CKM) syndrome remains poorly understood. This study examined the longitudinal associations between CKM syndrome stages and incident sensory impairments among middle-aged and older Chinese adults. Methods Data were derived from 12,815 participants (aged ≥ 45 years) in the China Health and Retirement Longitudinal Study (2011–2018), with a median follow-up of 6.5 years. CKM stages (0–4) were defined according to the 2023 American Heart Association framework. Incident hearing impairment (HI), vision impairment (VI), and dual sensory impairment (DSI) were assessed using validated self-reports. To address confounding, weighted marginal structural models (MSM) were employed using inverse probability of treatment weighting (IPTW). Sensitivity was further evaluated using E-value calculations and alternative reference groups. Results After IPTW adjustment, advanced CKM syndrome (Stage 4) was significantly associated with increased odds of incident HI (OR = 1.36, 95% CI: 1.05–1.74) and DSI (OR = 1.50, 95% CI: 1.04–2.15) compared with Stage 0 (optimal health). Although the association for VI was not statistically significant (OR = 1.29, 95% CI: 0.93–1.77), significant dose-response trends were observed across the CKM continuum for HI, VI (both P trend = 0.005), and DSI ( P trend < 0.001). Subgroup analyses revealed more pronounced associations among older adults, rural residents, and those with lower educational attainment. Sensitivity analyses and moderately high E-values supported the robustness of these findings against potential residual confounding. Conclusions Advanced CKM syndrome is longitudinally associated with higher odds of sensory impairments, particularly DSI, in a graded manner. These findings suggest that incorporating sensory health into CKM management frameworks may be crucial for mitigating the burden of functional decline in aging populations.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Adults / Aging / Antihypertensives / Biostatistics / Blood pressure / Body mass index / Cardiovascular disease / Cardiovascular-kidney-metabolic syndrome / Chronic diseases / Chronic illnesses / Diabetes / Disability / Dual sensory impairment / Environmental Health / Epidemiology / Exercise / Health aspects / Hearing impairment / Hearing loss / Hypertension / Impairment / Kidney diseases / Kidneys / Longitudinal studies / Longitudinal study / Marital status / Medical research / Medicine / Medicine & Public Health / Medicine, Experimental / Metabolic disorders / Metabolic syndrome / Middle age / Older people / Physiological aspects / Population / Population aging / Populations / Prevention / Public Health / Risk factors / Rural populations / Self report / Sensitivity analysis / Sensory evaluation / Sensory impairments / Socioeconomic factors / Statistical analysis / Structural models / Subgroups / Vaccine / Variance analysis / Vision impairment / Visual impairment