title: Executive dysfunction assessed by Clock-Drawing Test in older non-demented subjects with metabolic syndrome is not mediated by white matter lesions.
abstract: OBJECTIVE
  Metabolic syndrome (MetS) has been associated with greater occurrence of white matter hyperintensities (WMH). It remains uncertain whether MetS as a construct is associated with poorer cognitive performances. This study explores whether MetS is associated with poorer performances in global and domain-specific cognitive tests in older non-demented subjects independently of its individual components, WMH severity and other variables.
  
  
  METHODS
  MetS was diagnosed according to the National Cholesterol Education Program Adult Treatment Panel III definition. Brain magnetic resonance studies (1.5T) were performed. Deep and periventricular WMH were graded using the Fazekas scale. Subjects underwent the Mini-Mental State Examination, the Babcock Short Story Recall test and the Clock-Drawing Test (CDT).
  
  
  RESULTS
  Eighty community-dwellers aged 67-91 years were studied. Subjects with MetS (n = 35) had more severe WMH, and poorer performances on the CDT (P = 0.003) and the Babcock Short Story Recall test (P = 0.027). After multiple adjustment, MetS was inversely associated with CDT scores (B = -1.285; 95% confidence interval = -1.996--0.575; P = 0.001) but not with episodic memory. Results were not affected by WMH severity. Interestingly, none of the individual components of MetS predicted poorer cognitive performances.
  
  
  CONCLUSIONS
  Impairment in executive functions assessed by CDT may represent an early and specific sign of cognitive decline in older individuals with MetS. Future longitudinal studies are needed to better establish the predictive role of MetS on dementia and to demonstrate the possibility of dementia prevention by targeting MetS.
authors.affiliation: Division of Gerontology, Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, Sapienza University, Rome, Italy.|Department of Epidemiology, Surveillance and Promotion of Health, National Institute of Health, Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Viscogliosi
authors.affiliation: Division of Geriatrics, Casa di Cura Merry House, Rome, Italy.
authors.forename: Iulia Maria
authors.initials: IM
authors.lastname: Chiriac
authors.affiliation: Division of Gerontology, Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, Sapienza University, Rome, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Andreozzi
authors.affiliation: Division of Gerontology, Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, Sapienza University, Rome, Italy.
authors.forename: Evaristo
authors.initials: E
authors.lastname: Ettorre
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000209:etiology* / Q000503:physiopathology; D056344:Executive Function / Q000502:physiology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000473:pathology; D009483:Neuropsychological Tests; D066127:White Matter / Q000473:pathology*
keywords: Clock-Drawing Test; executive dysfunction; metabolic syndrome; prevention; white matter hyperintensities