title: Metabolic syndrome and dementia risk in a multiethnic elderly cohort.
abstract: 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.
authors.affiliation: Gertrude H. Sergievsky Center, Columbia University College of Physicians and Surgeons, New York, NY, USA.
authors.forename: Majon
authors.initials: M
authors.lastname: Muller
authors.forename: Ming-Xin
authors.initials: MX
authors.lastname: Tang
authors.forename: Nicole
authors.initials: N
authors.lastname: Schupf
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Manly
authors.forename: Richard
authors.initials: R
authors.lastname: Mayeux
authors.forename: José A
authors.initials: JA
authors.lastname: Luchsinger
mesh_terms: 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
chemical_list: D007328:Insulin; D014280:Triglycerides; D002784:Cholesterol