The association between Naples prognostic score and cognitive function in older adults: A cross-sectional study of NHANES 2011 to 2014.

The purpose of this study was to examine the association between the Naples prognostic score (NPS) and cognitive function in older adults. This cross-sectional study analyzed data from 2759 participants aged 60 years and older, with a mean age of 69.2 ± 6.6 years, from the National Health and Nutrition Examination Survey 2011 to 2014 data. Participants were categorized into 2 groups based on NPS: Group 1 (NPS = 0-2) and Group 2 (NPS = 3-4). Cognitive function was assessed using the Consortium to Establish a Registry for Alzheimer's Disease Word Learning subtest, Animal Fluency Test (AFT), and Digit Symbol Substitution Test (DSST). A global composite z-score was also calculated. Multivariable linear and logistic regression models were used to examine the associations between NPS and cognitive outcomes, with adjustments for sociodemographic and health-related confounders. In the fully adjusted models, a higher NPS was associated with lower AFT, DSST, and composite z-scores, whereas no significant association was observed with the Consortium to Establish a Registry for Alzheimer's Disease Word Learning subtest score. Compared with the low-NPS group, the high-NPS group had significantly lower AFT scores (β = -1.39, 95% confidence interval [CI]: -1.89 to -0.88), DSST scores (β = -1.82, 95% CI: -3.11 to -0.53), and composite z-scores (β = -0.43, 95% CI: -0.62 to -0.24), all with P < .05. Logistic regression further showed that the high-NPS group had higher odds of cognitive impairment according to the AFT (odds ratio = 1.41, 95% CI: 1.04-1.92) and DSST (odds ratio = 1.47, 95% CI: 1.00-2.14), both with P < .05. No statistically significant interactions were detected in the subgroup analyses (all P for interaction > .05). This study revealed the possible association between a high NPS and poorer cognitive performance, especially in terms of verbal fluency and processing speed. These findings suggest that the NPS may provide supplementary information for identifying individuals with poorer cognitive performance. However, the cross-sectional design precludes temporal or causal inference.