Cognitive impairment and frontal-subcortical geriatric syndrome are associated with metabolic syndrome in a stroke-free population.
BACKGROUND
Metabolic syndrome (Met.S) consists of a conglomeration of obesity, hypertension, glucose intolerance, and dislipidemia. Frontal-subcortical geriatric syndrome (FSCS) is caused by ischemic disruption of the frontal-subcortical network. It is unknown if Met.S is associated with FSCS.


METHODS
We evaluated 422 community-dwelling elderly (> or =60) in Brazil. FSCS was defined as the presence of at least one frontal release sign (grasping, palmomental, snout, or glabellar) plus coexistence of > or =3 the following criteria: (1) cognitive impairment, (2) late-onset depression, (3) neuromotor dysfunction, and (4) urgency incontinence. All values were adjusted to age and gender.


RESULTS
Met.S was present in 39.3% of all subjects. Cases without any of the FSCS components represented 37.2% ('successful neuroaging' group). People with 1-3 of the FSCS components ('borderline pathological neuroaging' group) were majority (52.6%), whereas those with 4-5 of these components (FSCS group) were minority (10.2%). Met.S was significantly associated with FSCS (OR=5.9; CI: 1.5-23.4) and cognitive impairment (OR=2.2; CI: 1.1-4.6) among stroke-free subjects. Number of Met.S components explained 30.7% of the variance on the number of FSCS criteria (P<0.001). If Met.S were theoretically removed from this population, prevalence of FSCS would decline by 31.6% and that of cognitive impairment by 21.4%.


CONCLUSIONS
Met.S was significantly associated with a 5.9 and 2.2 times higher chance of FSCS and cognitive impairment, respectively. Met.S might be a major determinant of 'successful' or 'pathological' neuroaging in western societies.
Roriz-Cruz
Matheus
M
Department of Neurology and Geriatrics, Kyoto University, Japan. matheusroriz@hotmail.com
Rosset
Idiane
I
Wada
Taizo
T
Sakagami
Teiji
T
Ishine
Masayuki
M
De Sá Roriz-Filho
Jarbas
J
Cruz
Thadeu R S
TR
Hosseinkhani
Mohsen
M
Rodrigues
Rosalina P
RP
Sudoh
Shinji
S
Arai
Hidenori
H
Wakatsuki
Yoshio
Y
Souza
Antonio C
AC
Nakagawa
Masanori
M
Kita
Toru
T
Matsubayashi
Kozo
K
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000378:metabolism / Q000473:pathology; D001938:Brazil / Q000453:epidemiology; D002560:Cerebrovascular Circulation / Q000502:physiology; D002561:Cerebrovascular Disorders / Q000453:epidemiology / Q000378:metabolism / Q000503:physiopathology; D003072:Cognition Disorders / Q000453:epidemiology* / Q000378:metabolism / Q000503:physiopathology; D015897:Comorbidity; D015140:Dementia, Vascular / Q000453:epidemiology* / Q000378:metabolism / Q000503:physiopathology; D003866:Depressive Disorder / Q000453:epidemiology / Q000378:metabolism / Q000503:physiopathology; D050171:Dyslipidemias / Q000150:complications / Q000503:physiopathology; D005260:Female; D005625:Frontal Lobe / Q000098:blood supply / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology* / Q000378:metabolism / Q000503:physiopathology; D008875:Middle Aged; D009069:Movement Disorders / Q000453:epidemiology / Q000378:metabolism / Q000503:physiopathology; D009434:Neural Pathways / Q000098:blood supply / Q000473:pathology* / Q000503:physiopathology; D015995:Prevalence; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology; D014549:Urinary Incontinence / Q000453:epidemiology / Q000378:metabolism / Q000503:physiopathology