Cognitive assessment in an elderly population with metabolic syndrome in Brazil

Abstract

Chronic degenerative conditions are very common in the elderly. According to medical literature, there is a correlation between cognitive impairment among elders and arterial hypertension/hyperglycemia which in turn are common diseases among the elderly population worldwide. Nonetheless, data on the association between cognitive impairment and Metabolic Syndrome (MetS) remains controversial.OBJECTIVETo compare the cognitive status of Brazilian elderly outpatients with and without MetS.METHODSA cross-sectional case-control study with 49 subjects (25 MetS and 24 controls) who underwent a global geriatric and neuropsychological assessment was carried out. The scores for cognitive abilities (sustained attention, alternating attention, immediate memory, working memory, memory - immediate recall, memory - delayed recall, memory - recognition, executive function, ideomotor praxis, constructive praxis, naming ability, verbal fluency) were compared with the data for the normal population and differences between case and control groups were analyzed using Student's t-test or the Mann-Whitney test.RESULTSForty-five patients (91.8%) were female, with a mean age of 73.9±5.9 years, and 3.0±1.0 years of schooling. A significant difference (p<0.01) was found between case and control groups regarding the MetS components. For cognitive abilities, no statistically significant difference was detected between the groups and all subjects presented low cognitive scores.CONCLUSIONThe results obtained in the present study showed that MetS was not associated with cognitive impairment in this population. Further prospective studies are necessary to investigate the influence of well-controlled MetS on cognitive performance among elders.

Metabolic Syndrome and cognitive decline in the elderly: A systematic review

“…Most of the studies were conducted in community settings, whereas 8 comprised convenience samples drawn from medical or nursing care facilities [ 13 – 20 ]. Educational level was generally low among studies; 7 of which included a significant number of subjects with formal education between 0 to 3 years [ 17 , 21 – 27 ], whereas 2 studies did not acknowledge the schooling of the sample [ 18 , 28 ].…”

“…Potential selection bias was identified in all the elected studies. Restricting the sample for specific age clusters [ 21 , 23 , 26 – 29 ], ethnic groups [ 13 , 31 ], gender [ 27 , 28 , 30 ] or clinical and functional status [ 14 , 15 , 17 – 20 , 24 , 32 – 35 ] may have compromised the generalization of the results. Response rate at baseline was lower than 70% in 3 of the studies [ 25 , 27 , 30 ], whereas other did not acknowledge the baseline participation rate [ 36 ].…”

“…Some modifications in the original criteria were observed in most of the studies. Inclusion of subjects under pharmacological treatment for systemic arterial hypertension, dyslipidemia and diabetes mellitus was generally accepted as alternatives for the need of identifying high blood pressure, high triglyceride, low HDL levels or high fasting glucose during clinical and laboratory assessment [ 13 , 14 , 17 , 20 – 24 , 26 , 28 , 29 , 32 , 33 , 35 , 37 ]. Specifically, a few studies included the use of antihypertensive and antidiabetic medications, but not of lipid-lowering drugs, as indicators of metabolic risk [ 15 , 16 , 18 , 27 , 34 , 36 ].…”

Functional magnetic resonance imaging response as an early biomarker of cognitive decline in elderly patients with metabolic syndrome

“…The clinical and demographic profile of the population has been previously described in detail (Shigaeff et al, 2013). MetS characteristics were significantly different between the MetS and control groups (p < 0.01).…”

“…The tests were randomized during each exam to avoid bias. For more detailed information about that neuropsychological assessment, see Shigaeff et al (2013).…”