title: Metabolic syndrome and cognition in patients with manifest atherosclerotic disease: the SMART study.
abstract: BACKGROUND
  It is unclear whether the metabolic syndrome (MetS) increases risk of cognitive dysfunction beyond the level expected from its individual components. We examined the association of MetS with cognitive dysfunction and assessed whether MetS increased risk of cognitive dysfunction more than that of the sum of its individual components.
  
  
  METHODS
  Data on 823 participants were used from the SMART-study, a cohort study among patients with atherosclerotic disease. MetS was defined according to the NCEP-ATPIII-criteria. Neuropsychological tests assessing memory, executive, and visuospatial functioning were performed. Regression analyses were performed to assess the association of MetS and its individual components with cognitive dysfunction. To examine whether MetS increased risk of cognitive dysfunction beyond its individual components we tested whether there was interaction on an additive scale by calculating the relative excess risk due to interaction (RERI).
  
  
  RESULTS
  MetS was associated with increased risk of memory (OR 2.0, 95% CI 1.1-3.3) and visuospatial dysfunction (OR 2.3, 95% CI 1.4-2.7) but not with executive dysfunction. However, risk of memory and visuospatial dysfunction for having all MetS components was not greater than that of the sum of the individual components (RERI 0.2 and -0.9).
  
  
  CONCLUSIONS
  In this population, MetS is related to increased risk of cognitive dysfunction but not more than that of the sum of its individual components.
authors.affiliation: Department of Internal Medicine, VU University Medical Cente, Amsterdam, The Netherlands. m.muller @ vumc.nl
authors.forename: Majon
authors.initials: M
authors.lastname: Muller
authors.forename: Fleur
authors.initials: F
authors.lastname: van Raamt
authors.forename: Frank L J
authors.initials: FL
authors.lastname: Visseren
authors.forename: Sandra
authors.initials: S
authors.lastname: Kalmijn
authors.forename: Mirjam I
authors.initials: MI
authors.lastname: Geerlings
authors.forename: Willem P T M
authors.initials: WP
authors.lastname: Mali
authors.forename: Yolanda
authors.initials: Y
authors.lastname: van der Graaf
mesh_terms: D050197:Atherosclerosis / Q000453:epidemiology*; D003072:Cognition Disorders / Q000453:epidemiology*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D056344:Executive Function; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008569:Memory Disorders / Q000453:epidemiology; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D015999:Multivariate Analysis; D009483:Neuropsychological Tests; D016017:Odds Ratio; D010468:Perceptual Disorders / Q000453:epidemiology; D012044:Regression Analysis; D012306:Risk