Metabolic syndrome and dementia risk in a multiethnic elderly cohort.
OBJECTIVE
The metabolic syndrome (MeSy) may be related to Alzheimer's disease (AD). Our aims were to investigate the association of the MeSy with incident dementia in a multiethnic elderly cohort in the United States.


METHODS
We conducted cross-sectional and prospective analyses in 2,476 men and women aged 65 years and older and with data available on the MeSy and dementia diagnosis in Northern New York City. MeSy was defined by the National Cholesterol Education Program Adult Treatment Program III and the European Group for the Study of Insulin Resistance criteria. Dementia was diagnosed using standard criteria.


RESULTS
No association was found between MeSy and prevalent dementia. After 4.4 years of follow-up, 236 individuals of the 1,833 without prevalent dementia developed dementia. MeSy was not associated with incident dementia. Of the components of the MeSy, diabetes and hyperinsulinemia were associated with an increased risk of incident AD [hazard ratio 1.4 (95% CI 1.0-2.1), and hazard ratio 1.4 (95% CI 0.9-2.7), respectively] and dementia associated with stroke [hazard ratio 1.9 (95% CI 1.1-3.1), and hazard ratio 2.3 (95% CI 1.1-4.7), respectively].


CONCLUSIONS
The MeSy was not associated with an increased dementia risk in a multiethnic elderly cohort, but diabetes and hyperinsulinemia were. In the elderly, examining diabetes and hyperinsulinemia separately may be preferable to using the MeSy as a risk factor.
Muller
Majon
M
Gertrude H. Sergievsky Center, Columbia University College of Physicians and Surgeons, New York, NY, USA.
Tang
Ming-Xin
MX
Schupf
Nicole
N
Manly
Jennifer J
JJ
Mayeux
Richard
R
Luchsinger
José A
JA
D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D002784:Cholesterol / Q000097:blood; D015331:Cohort Studies; D003704:Dementia / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D003920:Diabetes Mellitus / Q000453:epidemiology; D005006:Ethnicity; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D008137:Longitudinal Studies; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D012306:Risk; D014280:Triglycerides / Q000097:blood; D049629:Waist-Hip Ratio
D007328:Insulin; D014280:Triglycerides; D002784:Cholesterol