Screening cognition in the elderly with metabolic syndrome.
BACKGROUND
Metabolic syndrome reaches its highest prevalence in the elderly, and evidence suggests that metabolic syndrome could be an independent risk factor for cognitive impairment. The aims of this study were to detect whether patients with metabolic syndrome have lower cognition and to investigate whether there is a relationship with cognition and single metabolic syndrome components.


METHODS
We assessed fasting blood glucose (FBG), high-density lipoprotein cholesterol (HDL-C), triglycerides, high-sensitivity C-reactive protein (hsCRP), and anthropometric measurements. Metabolic syndrome was diagnosed according to National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. The population sample was divided into two groups according to the presence of metabolic syndrome. Cognitive function was investigated through the Mini-Mental State Examination (MMSE).


RESULTS
We enrolled 159 elderly subjects (mean age, 69.8±4.8 years). Seventy had metabolic syndrome. Metabolic syndrome subjects had higher hsCRP values (P<0.0001) and lower MMSE scores (P<0.0001) than those without metabolic syndrome. MMSE scores were significantly correlated with body mass index (BMI), hsCRP, metabolic syndrome, the number of metabolic syndrome components, and each of them. However, at multivariate regression analysis, only fasting blood glucose [FBG; B=-0.046; 95% confidence interval (CI) -0.066 to -0.028; P<0.0001] and the number of metabolic syndrome components (B=-0.317; 95% CI -0.572 to -0.010; P=0.042) were found to be independent predictors of lower MMSE scores.


CONCLUSIONS
We found that subjects with metabolic syndrome have lower MMSE scores than those without, even without symptomatic cognitive impairment, and that the number of metabolic abnormalities is independently associated to lower MMSE scores. We suggest that these patients should always undergo cognitive screening to prevent more severe outcomes.
Predictive Medicine Unit, Sapienza University, Rome, Italy. giovanni.viscogliosi@libero.it
Giovanni
G
Viscogliosi
Paola
P
Andreozzi
Iulia Maria
IM
Chiriac
Elisa
E
Cipriani
Adriana
A
Servello
Evaristo
E
Ettorre
Vincenzo
V
Marigliano
D017668:Age of Onset; D000368:Aged; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis; D008076:Cholesterol, HDL / Q000097:blood; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D024821:Metabolic Syndrome / Q000150:complications* / Q000453:epidemiology / Q000523:psychology*; D008875:Middle Aged; D009483:Neuropsychological Tests; D015995:Prevalence; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood
D008076:Cholesterol, HDL; D014280:Triglycerides; D002097:C-Reactive Protein