The metabolic syndrome in a memory clinic population: relation with clinical profile and prognosis.
BACKGROUND
The metabolic syndrome (MetS) refers to a cluster of cardiovascular risk factors that is associated with an increased risk of cognitive impairment and dementia. It is unclear however, if the presence of the MetS is associated with a particular clinical profile or a different prognosis in patients with cognitive complaints or early dementia.


OBJECTIVE
To compare 1) the clinical profile and 2) the prognosis of patients attending a memory clinic according to the presence or absence of MetS.


METHODS
Longitudinal cohort.


METHODS
Memory clinic.


METHODS
We included and followed 86 consecutive patients (average age of 66.7 (SD 9.7)) from the Amsterdam Dementia Cohort with an MMSE>22.


METHODS
Clinical profile (neuropsychological examination, brain MRI, cerebrospinal fluid (CSF) biomarkers, clinical diagnosis) on an initial standardized diagnostic assessment was compared according to MetS status. Progression to dementia was assessed in initially nondemented patients (subjective complaints n=40, mild cognitive impairment n=24, follow-up available in 59).


RESULTS
35 (41%) patients met the MetS criteria. Demographics were similar between patients with or without the MetS. At baseline, diagnosis, cognitive performance, severity of degenerative or vascular abnormalities on MRI, and CSF amyloid and tau levels did not differ between the groups (all p>0.05). Among nondemented patients, however, MetS was associated with worse performance on executive function, attention & speed and visuoconstructive ability (z-scores, p<0.05). During a mean follow-up of 3.4years a similar proportion of patients with (4; 17%) and without (6; 17%) the MetS progressed to dementia (p=0.45).


CONCLUSIONS
Among nondemented patients presenting at a memory clinic MetS was associated with slightly worse cognitive performance (worse on tasks assessing executive functions, visuo-constructive ability, attention & speed), but conversion rate to dementia was not increased.
Department of Neurology, Brain Centre Rudolf Magnus Institute, University Medical Centre Utrecht, Utrecht, The Netherlands; Alzheimer Centre, VU University Medical Centre, Amsterdam, The Netherlands. Electronic address: l.g.exalto-2@umcutrecht.nl.
Lieza G
LG
Exalto
Department of Epidemiology and Biostatistics, VU University, Amsterdam, The Netherlands; Alzheimer Centre, VU University Medical Centre, Amsterdam, The Netherlands.
Wiesje M
WM
van der Flier
Department of Neurology, Medical Centre Haaglanden, The Hague, The Netherlands.
Caroline J M
CJM
van Boheemen
Department of Neurology, Brain Centre Rudolf Magnus Institute, University Medical Centre Utrecht, Utrecht, The Netherlands.
L Jaap
LJ
Kappelle
Department of Radiology, VU University Medical Centre, Amsterdam, The Netherlands; Department of Physics and Medical Technology, VU University Medical Centre, Amsterdam, The Netherlands; Alzheimer Centre, VU University Medical Centre, Amsterdam, The Netherlands.
Hugo
H
Vrenken
Neurochemistry Lab and Biobank, Department of Clinical Chemistry, VU University Medical Centre, Amsterdam, The Netherlands; Alzheimer Centre, VU University Medical Centre, Amsterdam, The Netherlands.
Charlotte
C
Teunissen
Department of Medical Psychology, VU University Medical Centre, Amsterdam, The Netherlands; Alzheimer Centre, VU University Medical Centre, Amsterdam, The Netherlands.
Ted
T
Koene
Department of Neurology, VU University Medical Centre, Amsterdam, The Netherlands; Alzheimer Centre, VU University Medical Centre, Amsterdam, The Netherlands.
Phillip
P
Scheltens
Department of Neurology, Brain Centre Rudolf Magnus Institute, University Medical Centre Utrecht, Utrecht, The Netherlands.
Geert Jan
GJ
Biessels
D000368:Aged; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000209:etiology; D003704:Dementia / Q000175:diagnosis* / Q000209:etiology; D018450:Disease Progression; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis* / Q000209:etiology; D024821:Metabolic Syndrome / Q000150:complications / Q000175:diagnosis*; D008875:Middle Aged; D011379:Prognosis
Atrophy; Cerebrospinal fluid (CSF) biomarkers; Cognitive performance; Dementia; Metabolic syndrome; Progression; Vascular lesions