Metabolic Syndrome and Neurocognition Among Diverse Middle-Aged and Older Hispanics/Latinos: HCHS/SOL Results

González, Hector M.; Tarraf, Wassim; Vásquez, Priscilla M.; Sanderlin, Ashley H.; Rosenberg, Natalya; Davis, Sonia M.; Rodríguez, Carlos J.; Gallo, Linda C.; Thyagarajan, Bharat; Daviglus, Martha L.; Khambaty, Tasneem; Cai, Jianwen; Schneiderman, Neil

doi:10.2337/dc17-1896

Cited by 19 publications

(14 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It is unclear as to whether or not this pattern is true for Hispanics. Interestingly, in a study of metabolic syndrome, the presence of multiple cardiovascular risk factors among Hispanics was predictive of episodic memory only among late middle age individuals (González et al 2018). In contrast, executive functions were negatively impacted across all age groups in the presence of metabolic syndrome (González et al 2018), which is consistent with the present finding of an association with executive functions but not memory.…”

Section: Discussionsupporting

confidence: 88%

“…This is particularly striking given the increased prevalence of obesity among this population (Daviglus et al 2012). In studies of Hispanics with metabolic syndrome, obesity tends to fail to predict cognitive functions when taking other factors into account, including age, gender, education, Hispanic/ Latino subgroup, and depressive symptoms (González et al 2018). However, in a predominantly Mexican American sample, higher waist-to-hip ratio, a measure of central body fat, was associated with lower hippocampal volumes and greater white matter hyperintensities even when controlling for other cardiovascular factors including cholesterol level, blood pressure, BMI, and glucose and insulin levels (Jagust et al 2005).…”

mentioning

confidence: 99%

See 1 more Smart Citation

The impact of cardiovascular risk factors on cognition in Hispanics and non-Hispanic whites

et al. 2019

View full text Add to dashboard Cite

Among non-Hispanic whites, cardiovascular risk factors are associated with increased mortality and poorer cognition. Prevalence of cardiovascular risk factors among aging Hispanics is also high and Hispanics generally have poorer access to healthcare, yet they tend to have advantageous cardiovascular disease rates and outcomes and live longer than non-Hispanic whites, an epidemiological phenomenon commonly referred to as the Hispanic or Latino health paradox. Although robust data support these ethnic benefits on physical health and mortality, it is unknown if it extends to include cognition resilience advantages in older adulthood. The present study compared relationships between cardiovascular risk and cognition (executive functions and episodic memory) in late middle age and older Hispanics (n = 87) and non-Hispanic whites (n = 81). Participants were selected from the National Alzheimer's Coordinating Center and Alzheimer's Disease Neuroimaging Initiative databases. Hispanics and non-Hispanic white groups were matched on age (50-94 yr, mean age = 72 yr), education, gender, cognitive status (i.e., cognitively healthy versus mildly cognitively impaired), and apolipoprotein E4 status. History of hypertension and higher body mass index were both associated with poorer executive functions among Hispanics but not non-Hispanic whites. Our findings suggest greater vulnerability to impairments in executive functions among Hispanics with hypertension and obesity, contrary to the notion of a Hispanic health paradox for cognitive aging.

show abstract

Section: Discussionsupporting

confidence: 88%

mentioning

confidence: 99%

The impact of cardiovascular risk factors on cognition in Hispanics and non-Hispanic whites

et al. 2019

View full text Add to dashboard Cite

show abstract

“…While the underlying mechanisms to explain these associations are beyond the scope of this cross-sectional study, potential underpinnings may be found in the literature. For example, the fact that our TG results did not withstand additional adjustments for hypertension and diabetes suggests that the negative association of TG levels on working memory scores in Hispanics/Latinos of this study may reflect the combined role of TG in the metabolic syndrome and overall cardiovascular disease risk factor burden as previously reported (Gonzalez et al, 2018;Levin et al, 2014;Warsch et al, 2013;Yaffe et al, 2007;Zeki Al Hazzouri et al, 2013). The fact that female sex modified the negative association of TG levels on working memory, withstanding all adjustments, including those for hypertension and diabetes further suggests that the higher overall cardiovascular disease risk factor burden known to exist in Hispanic/Latino men compared to women (Daviglus et al, 2016;Daviglus et al, 2012) may have diluted the effect of TG in the main analyses.…”

Section: Discussionmentioning

confidence: 53%

“…Thus, more work is needed studying lipid levels and cognition in Hispanic/Latinos. Work to date in Hispanics/Latinos has often been done within the context of metabolic syndrome (e.g., Gonzalez et al, 2018) with fewer studies focused on a complete lipid panel. The majority of studies suggest that metabolic syndrome and/or global cardiovascular disease risk factor burden is associated with cognition including declarative memory, working memory, and information processing speed in cohorts either including or exclusively composed of Hispanics/Latinos (Del Brutto, Mera, & Zambrano, 2016;Lamar et al, 2019;Levin et al, 2014;Warsch et al, 2013;Yaffe et al, 2007;Zeki Al Hazzouri et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Associations of Lipid Levels and Cognition: Findings from the Hispanic Community Health Study/Study of Latinos

Lamar

Durazo‐Arvizu

Rodríguez

et al. 2019

J Int Neuropsychol Soc

Self Cite

View full text Add to dashboard Cite

Objective:Hispanics/Latinos in the United States are less aware of their cholesterol levels and have a higher burden of associated adverse cardiovascular and cerebrovascular outcomes than non-Latino whites. Investigations of the associations between cholesterol levels and cognition in this population have often occurred within the context of metabolic syndrome and are limited to select lipids despite the fact that triglycerides (TGs) may be more relevant to the health of Hispanics/Latinos.Methods:Baseline data from the Hispanic Community Health Study/Study of Latinos, collected from 2008 to 2011, was used to investigate the associations of lipid levels (i.e., TG, total cholesterol, TC; low-density and high-density lipoprotein cholesterol, LDL-C and HDL-C) with cognition (i.e., learning, memory, verbal fluency, and digit symbol substitution, DSS), adjusting for relevant confounders.Results:In 7413 participants ages 45 to 74 years from Central American, Cuban, Dominican, Mexican, Puerto Rican, and South American backgrounds, separate, fully adjusted linear regression models revealed that TG levels were inversely associated with DSS performance; however, this relationship was no longer significant once additional cardiovascular disease risk factors were added to the model (p = .06). TC and LDL-C levels (separately) were positively associated with learning and verbal fluency regardless of adjustments (p-values < .05). Separate analyses investigating the effect modification by background and sex revealed a particularly robust association between TC levels and DSS performance for Puerto Ricans and Central Americans (albeit in opposite directions) and an inverse relationship between TG levels and DSS performance for women (p-values < .02).Conclusions:It is important to consider individual lipid levels and demographic characteristics when investigating associations between cholesterol levels and cognition in Hispanics/Latinos.

show abstract

“…In recent years, the relationship between cognitive function and metabolic syndrome (MetS) has been widely studied [1,2]. MetS has been found to be associated with a decline in areas related to executive function [3,4] because of multiple risk factors, including hypertension, dyslipidemia, impaired glucose homeostasis, and abdominal obesity.…”

Section: Introductionmentioning

confidence: 99%

Exergaming Improves Executive Functions in Patients With Metabolic Syndrome: Randomized Controlled Trial

et al. 2019

JMIR Serious Games

View full text Add to dashboard Cite

Background Recent studies indicate that participation in exercise-related games can improve executive function, attention processing, and visuospatial skills. Objective The aim of this study was to investigate whether exercise via exergaming (EXG) can improve executive function in patients with metabolic syndrome (MetS). Methods A total of 22 MetS patients were recruited and randomly assigned to an EXG group or a treadmill exercise (TE) group. The reaction time (RT) and electrophysiological signals from the frontal (Fz), central (Cz), and parietal (Pz) cortices were collected during a Stroop task after 12 weeks of exercise. Results During the Stroop congruence (facilitation) judgment task, both the EXG and TE groups showed significantly faster RT after 12 weeks of exercise training. For N200 amplitude, the EXG group demonstrated significantly increased electrophysiological signals from the Fz and Cz cortices. These changes were significantly larger in the EXG group than in the TE group. Separately, for the P300 amplitude, the EXG groups presented significantly increased electrophysiological signals from the Fz, Cz, and Pz cortices, whereas the TE group showed significantly increased electrophysiological signals from the Cz and Pz cortices only. During the Stroop incongruence (interference) judgment task, both the EXG and TE groups showed significantly faster RT. For P300 amplitude, the EXG group had significantly increased electrophysiological signals from the Fz and Cz cortices only, whereas the TE group had significantly increased electrophysiological signals from the Fz, Cz, and Pz cortices. Conclusions EXG improves executive function in patients with MetS as much as normal aerobic exercise does. In particular, a unique benefit of EXG beyond increased aerobic capacity is the improved selective attention among cognitive functions. Thus, EXG could be recommended to someone who needs to improve their brain responses of concentration and judgment as well as physical fitness. Trial Registration ClinicalTrials.gov NCT04015583; https://clinicaltrials.gov/ct2/show/NCT04015583

show abstract

Metabolic Syndrome and Neurocognition Among Diverse Middle-Aged and Older Hispanics/Latinos: HCHS/SOL Results

Abstract: We found that MetS was associated with lower neurocognitive function, particularly in midlife. Our findings support and extend current hypotheses that midlife may be a particularly vulnerable developmental period for unhealthy neurocognitive aging.

Cited by 19 publications

References 32 publications

The impact of cardiovascular risk factors on cognition in Hispanics and non-Hispanic whites

The impact of cardiovascular risk factors on cognition in Hispanics and non-Hispanic whites

Associations of Lipid Levels and Cognition: Findings from the Hispanic Community Health Study/Study of Latinos

Exergaming Improves Executive Functions in Patients With Metabolic Syndrome: Randomized Controlled Trial

Contact Info

Product

Resources

About