The Metabolic Syndrome and Cognitive Performance: The Northern Manhattan Study

Abstract

Background: The metabolic syndrome (MetS) is a risk factor for diabetes, stroke, myocardial infarction, and increased mortality, and has been associated with cognition in some populations. We hypothesized that MetS would be associated with lower Mini-Mental State Examination (MMSE) scores in a multi-ethnic population, and that MetS is a better predictor of cognition than its individual components or diabetes. Methods: We conducted a cross-sectional analysis among 3,150 stroke-free participants. MetS was defined by the modified National Cholesterol Education Program guidelines-Adult Treatment Panel III (NCEP-ATPIII) criteria. Linear regression and polytomous logistic regression estimated the association between MMSE score and MetS, its individual components, diabetes, and inflammatory biomarkers. Results: MetS was inversely associated with MMSE score (unadjusted β = –0.67; 95% CI –0.92, –0.41). Adjusting for potential confounders, MetS was associated with lower MMSE score (adjusted β = –0.24; 95% CI –0.47, –0.01), but its individual components and diabetes were not. Those with MetS were more likely to have an MMSE score of <18 than a score of ≧24 (adjusted OR = 1.94; 95% CI 1.26, 3.01). There was an interaction between MetS and race-ethnicity, such that MetS was associated with lower MMSE score among non-Hispanic whites and Hispanics but not non-Hispanic blacks. Conclusions: MetS was associated with lower cognition in a multi-ethnic population. Further studies of the effect of MetS on cognition are warranted, and should account for demographic differences.

Metabolic syndrome correlates poorly with cognitive performance in stroke-free community-dwelling older adults: a population-based, cross-sectional study in rural Ecuador

“…We found no correlation between metabolic syndrome and cognitive performance. In this view, results from the literature are inconsistent, with some studies showing no association between metabolic syndrome and poor cognitive performance [6,20], while others showing a positive relationship [7][8][9]21]. Irrespective of differences in the population studied or the tests used for cognitive assessment, a major difference between these studies has been the lack of consistency in the selection of potential confounders to be used as covariates in the statistical analysis.…”

“…Recent studies have investigated a possible correlation between metabolic syndrome and cognitive decline. Such studies have been inconsistent, with some suggesting a direct association between both conditions, while others showing no relationship [4][5][6][7][8][9]. According to a comprehensive review, variations in the criteria used for definition of metabolic syndrome together with differences and reliability of the tests selected for cognitive assessment may explain-at least in part-this lack of consensus [10].…”

What Metabolic Syndrome Contributes to Brain Outcomes in African American & Caucasian Cohorts

“…This leaves in doubt whether meeting one or two but not three or more criteria for MetS has an impact on cognitive functioning [15]. Others debate the importance of meeting criteria for MetS [17] versus displaying significant disease severity across individual component parts [18] when investigating cognitive impairment. Thus, incremental MetS risk may be as important to cognitive functioning as MetS and/or individual vascular diagnoses when investigating brain aging in affected individuals.…”

Vascular Dementia

“…[41] In the Northern Manhattan study, those with metabolic syndrome had worse mini-mental scores, defined by a score < 18, (OR = 1.94; 95 % CI 1.26, 3.01) compared to those without metabolic syndrome. [42]…”