title: The metabolic syndrome and cognitive performance: the Northern Manhattan Study.
abstract: BACKGROUND
  The metabolic syndrome (MetS) is a risk factor for diabetes, stroke, myocardial infarction, and increased mortality, and has been associated with cognition in some populations. We hypothesized that MetS would be associated with lower Mini-Mental State Examination (MMSE) scores in a multi-ethnic population, and that MetS is a better predictor of cognition than its individual components or diabetes.
  
  
  METHODS
  We conducted a cross-sectional analysis among 3,150 stroke-free participants. MetS was defined by the modified National Cholesterol Education Program guidelines-Adult Treatment Panel III (NCEP-ATPIII) criteria. Linear regression and polytomous logistic regression estimated the association between MMSE score and MetS, its individual components, diabetes, and inflammatory biomarkers.
  
  
  RESULTS
  MetS was inversely associated with MMSE score (unadjusted β = -0.67; 95% CI -0.92, -0.41). Adjusting for potential confounders, MetS was associated with lower MMSE score (adjusted β = -0.24; 95% CI -0.47, -0.01), but its individual components and diabetes were not. Those with MetS were more likely to have an MMSE score of <18 than a score of ≥ 24 (adjusted OR = 1.94; 95% CI 1.26, 3.01). There was an interaction between MetS and race-ethnicity, such that MetS was associated with lower MMSE score among non-Hispanic whites and Hispanics but not non-Hispanic blacks.
  
  
  CONCLUSIONS
  MetS was associated with lower cognition in a multi-ethnic population. Further studies of the effect of MetS on cognition are warranted, and should account for demographic differences.
authors: Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
authors: Julio R
authors: JR
authors: Vieira
authors: Mitchell S V
authors: MS
authors: Elkind
authors: Yeseon Park
authors: YP
authors: Moon
authors: Tatjana
authors: T
authors: Rundek
authors: Bernadette
authors: B
authors: Boden-Albala
authors: Myunghee C
authors: MC
authors: Paik
authors: Ralph L
authors: RL
authors: Sacco
authors: Clinton B
authors: CB
authors: Wright
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition; D003072:Cognition Disorders / Q000150:complications / Q000453:epidemiology* / Q000208:ethnology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D024821:Metabolic Syndrome / Q000150:complications / Q000453:epidemiology* / Q000208:ethnology; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D047888:Receptors, Tumor Necrosis Factor, Type I / Q000097:blood; D012307:Risk Factors
chemical_list: D047888:Receptors, Tumor Necrosis Factor, Type I