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ORIGINAL RESEARCH article
Front. Neurol.
Sec. Neuroepidemiology
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1527302
Systemic Inflammation Markers (SII and SIRI) as Predictors of Cognitive Performance: Evidence from NHANES 2011-2014
Provisionally accepted- 1School of Public Health, Zunyi Medical University, Zunyi, China
- 2Zunyi Medical University, Zunyi, Guizhou Province, China
- 3Department of Nursing，Guizhou Provincial People's Hospital, Guiyang, China
- 4School of Nursing，Guizhou University of Traditional Chinese Medicine, Guiyang, China
- 5Nursing school, Zunyi Medical University, Zunyi, China
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Background: Neuroinflammation is linked to cognitive function. However, epidemiological research on two emerging inflammation markers-the systemic immune-inflammation index (SII) and the systemic inflammation response index (SIRI)-remains limited in the context of cognitive performance. This study investigates the relationship between SII, SIRI, and cognitive performance in older adults.Methods: This cross-sectional analysis included 2,194 participants from the 2011-2014 National Health and Nutrition Examination Survey (NHANES) who met eligibility criteria. Logistic regression, subgroup analysis, and restricted cubic spline modeling were used to assess the associations between cognitive performance and inflammation markers, specifically SII and SIRI.Results:After adjusting for population weights, participants with low cognitive function had an SII of 541.54 (95% CI: 360.00-796.50, P = 0.037) and an SIRI of 1.28 (95% CI: 0.82-2.18, P = 0.031). In fully adjusted models, higher levels of both SII (OR = 0.858, 95% CI: 0.856-0.859) and SIRI (OR = 0.891, 95% CI: 0.889-0.892) were significantly associated with lower odds of normal cognitive function, indicating an increased risk of cognitive impairment. Neutrophil-related markers (NC, NLR, SIRI) exhibited the strongest inverse associations. Subgroup analysis showed more consistent associations for SIRI across demographic and behavioral factors, while SII displayed fewer. RCS analysis indicated a stronger non-linear relationship for SIRI (P = 0.005) compared to SII (P = 0.018) after full adjustment.Conclusion: This study suggests a positive association between SII, SIRI, and cognitive function, with a more pronounced relationship for SIRI. These findings highlight the potential of SIRI as a novel, accessible marker for predicting cognitive impairment risk.
Keywords: cognitive performance, Inflammatory markers, systemic immune-inflammation index, system-inflammation response index, NHANES
Received: 14 Nov 2024; Accepted: 17 Apr 2025.
Copyright: © 2025 Wang, Li, Wen, Li, Zhu, Zhang and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Juan Li, Department of Nursing，Guizhou Provincial People's Hospital, Guiyang, China
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