title: The metabolic syndrome and 10-year cognitive and functional decline in very old men. A population-based study.
abstract: OBJECTIVE
  To describe longitudinal relationships of metabolic syndrome (MetS) to cognitive decline and functional disability in a sample of older non-institutionalized men.
  
  
  METHODS
  data from 1991 to 2000 of the Italian cohorts of the Finland, Italy, the Netherlands, Elderly (FINE) study, were used. Global cognitive function and functional disability, defined as limitations in mobility, basic (ADLs) and instrumental activities of daily living (IADLs) were screened in 1991 and 2000. MetS was defined according to the NCEP ATP-III criteria.
  
  
  RESULTS
  The study sample consisted of 195 men, baseline age 76.1±3.1years. Baseline MetS was prospectively associated with greater 10-year cognitive and functional decline in ADLs and IADLs. After multiple adjustment including age, education, marital status, ApoE ε4 allele, cerebrovascular disease and initial cognitive and depressive status, MetS predicted cognitive decline (B=-1.684, 95%CI=-2.202 to -1.167, p<0.001) and risk of IADLs (OR=1.09, 95% CI=1.01-1.20, p=0.048) and ADLs disability (OR=1.35, 95%CI=1.12-1.62, p<0.001). Interestingly, such associations were not attributable to individual altered components of MetS nor to their sum. Incident disability in ADLs and IADLs were not explained by parallel decline in cognitive function.
  
  
  CONCLUSIONS
  MetS as an entity was associated with accelerated cognitive and functional decline in a population-based sample of very old men.
authors.affiliation: Department of Epidemiology, Surveillance and Promotion of Health, National Institute of Health, Rome, Italy; Department of Gerontology, Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, Sapienza University, Rome, Italy. Electronic address: giovanni.viscogliosi@libero.it.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Viscogliosi
authors.affiliation: Department of Epidemiology, Surveillance and Promotion of Health, National Institute of Health, Rome, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Donfrancesco
authors.affiliation: Department of Epidemiology, Surveillance and Promotion of Health, National Institute of Health, Rome, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Palmieri
authors.affiliation: Department of Epidemiology, Surveillance and Promotion of Health, National Institute of Health, Rome, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Giampaoli
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D060825:Cognitive Dysfunction / Q000453:epidemiology*; D015331:Cohort Studies; D004185:Disability Evaluation; D005060:Europe / Q000453:epidemiology; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*
keywords: Cognitive decline; Functional disability; Incidence; Metabolic syndrome