title: Effects of head circumference and metabolic syndrome on cognitive decline.
abstract: BACKGROUND
  Brain volume progressively decreases with an increase in atrophy, and the brain becomes more susceptible to degenerative brain diseases such as Alzheimer's disease. Metabolic syndrome has also been associated with an increased risk of cognitive decline in the elderly.
  
  
  OBJECTIVE
  In this study, we aimed to examine the effects of head circumference and metabolic syndrome on cognitive decline.
  
  
  METHODS
  This study was part of a longitudinal study conducted on Koreans aged 60 years or older. We analyzed a final sample of 596 Korean participants with complete baseline and 2-year follow-up data. The cognitive function of the subjects was assessed using the Korean version of the Mini Mental State Examination (MMSE). Head circumference was measured from the glabella to the occipital protuberance using a measuring tape. Metabolic syndrome was defined according to the NCEP-ATP III standards. Central obesity was assessed on the basis of waist-circumference values, in accordance with the World Health Organization Western Pacific Region report on Asians. We used a longitudinal factorial design in which the MMSE score was the dependent variable, and head circumference and metabolic syndrome were considered as factors.
  
  
  RESULTS
  After adjusting the results for age, gender, education, height, weight, baseline MMSE, and number of follow-up years, we observed that smaller head circumference and the presence of metabolic syndrome were independently associated with rapid cognitive decline.
  
  
  CONCLUSIONS
  All these findings suggest that smaller head circumference and the presence of metabolic syndrome have additive effects on cognitive decline.
authors.affiliation: Department of Psychiatry, CHA University, Bundang Cha Medical Center, Seongnam, South Korea.
authors.forename: Kang Soo
authors.initials: KS
authors.lastname: Lee
authors.forename: Jin-Sup
authors.initials: JS
authors.lastname: Eom
authors.forename: Hae-Kwan
authors.initials: HK
authors.lastname: Cheong
authors.forename: Byoung Hoon
authors.initials: BH
authors.lastname: Oh
authors.forename: Chang Hyung
authors.initials: CH
authors.lastname: Hong
mesh_terms: D000368:Aged; D000375:Aging / Q000473:pathology*; D001284:Atrophy; D001921:Brain / Q000473:pathology*; D002508:Cephalometry / Q000706:statistics & numerical data*; D003072:Cognition Disorders / Q000453:epidemiology / Q000473:pathology*; D005260:Female; D006257:Head / Q000033:anatomy & histology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000473:pathology*; D008875:Middle Aged; D009483:Neuropsychological Tests; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors