Modeling metabolic syndrome and its association with cognition: the Northern Manhattan study.
Metabolic syndrome (MetS) is a clustering of vascular risk factors and is associated with increased risk of cardiovascular disease. Less is known about the relationship between MetS and cognition. We examined component vascular risk factors of MetS as correlates of different cognitive domains. The Northern Manhattan Study (NOMAS) includes 1290 stroke-free participants from a largely Hispanic multi-ethnic urban community. We used structural equation modeling (SEM) to model latent variables of MetS, assessed at baseline and an average of 10 years later, at which time participants also underwent a full cognitive battery. The two four-factor models, of the metabolic syndrome (blood pressure, lipid levels, obesity, and fasting glucose) and of cognition (language, executive function, psychomotor, and memory), were each well supported (CFI=0.97 and CFI=0.95, respectively). When the two models were combined, the correlation between metabolic syndrome and cognition was -.31. Among the metabolic syndrome components, only blood pressure uniquely predicted all four cognitive domains. After adjusting for age, gender, race/ethnicity, education, smoking, alcohol, and risk factor treatment variables, blood pressure remained a significant correlate of all domains except memory. In this stroke-free race/ethnically diverse community-based cohort, MetS was associated with cognitive function suggesting that MetS and its components may be important predictors of cognitive outcomes. After adjusting for sociodemographic and vascular risk factors, blood pressure was the strongest correlate of cognitive performance. Findings suggest MetS, and in particular blood pressure, may represent markers of vascular or neurodegenerative damage in aging populations.
1Evelyn F. McKnight Brain Institute,Department of Neurology,University of Miami Leonard M. Miller School of Medicine,Miami,Florida.
Bonnie E
BE
Levin
2Deparment of Psychology,University of Miami,Miami,Florida.
Maria M
MM
Llabre
1Evelyn F. McKnight Brain Institute,Department of Neurology,University of Miami Leonard M. Miller School of Medicine,Miami,Florida.
Chuanhui
C
Dong
3Department of Neurology,Columbia University,New York,New York.
Mitchell S V
MS
Elkind
4Cognitve Neuroscience Division,Department of Neurology,Columbia University,New York,New York.
Yaakov
Y
Stern
1Evelyn F. McKnight Brain Institute,Department of Neurology,University of Miami Leonard M. Miller School of Medicine,Miami,Florida.
Tatjana
T
Rundek
1Evelyn F. McKnight Brain Institute,Department of Neurology,University of Miami Leonard M. Miller School of Medicine,Miami,Florida.
Ralph L
RL
Sacco
1Evelyn F. McKnight Brain Institute,Department of Neurology,University of Miami Leonard M. Miller School of Medicine,Miami,Florida.
Clinton B
CB
Wright
D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D003072:Cognition Disorders / Q000453:epidemiology* / Q000208:ethnology; D005006:Ethnicity; D005215:Fasting / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007858:Learning; D008297:Male; D008659:Metabolic Diseases / Q000453:epidemiology* / Q000208:ethnology / Q000503:physiopathology / Q000523:psychology*; D008875:Middle Aged; D008962:Models, Theoretical; D009483:Neuropsychological Tests; D009519:New York City; D012189:Retrospective Studies; D012737:Sex Factors; D014652:Vascular Diseases / Q000175:diagnosis / Q000453:epidemiology; D014705:Verbal Behavior; D055105:Waist Circumference