title: Glycemia but not the Metabolic Syndrome is Associated with Cognitive Decline: Findings from the European Male Ageing Study.
abstract: OBJECTIVE
  Previous research has indicated that components of the metabolic syndrome (MetS), such as hyperglycemia and hypertension, are negatively associated with cognition. However, evidence that MetS itself is related to cognitive performance has been inconsistent. This longitudinal study investigates whether MetS or its components affect cognitive decline in aging men and whether any interaction with inflammation exists.
  
  
  METHODS
  Over a mean of 4.4 years (SD ± 0.3), men aged 40-79 years from the multicenter European Male Ageing Study were recruited. Cognitive functioning was assessed using the Rey-Osterrieth Complex Figure (ROCF), the Camden Topographical Recognition Memory (CTRM) task, and the Digit Symbol Substitution Test (DSST). High-sensitivity C-reactive protein (hs-CRP) levels were measured using a chemiluminescent immunometric assay.
  
  
  RESULTS
  Overall, 1,913 participants contributed data to the ROCF analyses and 1,965 subjects contributed to the CTRM and DSST analyses. In multiple regression models the presence of baseline MetS was not associated with cognitive decline over time (p > 0.05). However, logistic ordinal regressions indicated that high glucose levels were related to a greater risk of decline on the ROCF Copy (β = -0.42, p < 0.05) and the DSST (β = -0.39, p < 0.001). There was neither a main effect of hs-CRP levels nor an interaction effect of hs-CRP and MetS at baseline on cognitive decline.
  
  
  CONCLUSIONS
  No evidence was found for a relationship between MetS or inflammation and cognitive decline in this sample of aging men. However, glycemia was negatively associated with visuoconstructional abilities and processing speed.
authors.affiliation: Gerontology and Geriatrics, Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium. Electronic address: margot.overman@ndcn.ox.ac.uk.
authors.forename: Margot J
authors.initials: MJ
authors.lastname: Overman
authors.affiliation: Clinical & Cognitive Neurosciences, Institute of Brain, Behaviour and Mental Healthy, The University of Manchester, UK.
authors.forename: Neil
authors.initials: N
authors.lastname: Pendleton
authors.affiliation: Arthritis Research UK Centre for Epidemiology, Institute of Inflammation and Repair, the University of Manchester, Manchester, UK; NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
authors.forename: Terence W
authors.initials: TW
authors.lastname: O'Neill
authors.affiliation: Department of Obstetrics, Gynaecology and Andrology, Albert Szent-György Medical University, Szeged, Hungary.
authors.forename: Gyorgy
authors.initials: G
authors.lastname: Bartfai
authors.affiliation: Department of Medicine, Instituto Salud Carlos III, Complejo Hospitalario Universitario de Santiago (CHUS), A Coruña, Spain.
authors.forename: Felipe F
authors.initials: FF
authors.lastname: Casanueva
authors.affiliation: Endocrinology Unit, University of Florence, Florence, Italy.
authors.forename: Gianni
authors.initials: G
authors.lastname: Forti
authors.affiliation: Sexual Medicine and Andrology Unit, Department of Experimental, Clinical, and Biomedical Sciences, University of Florence, Florence, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Rastrelli
authors.affiliation: Reproductive Medicine Centre, Skåne University Hospital, University of Lund, Lund, Sweden.
authors.forename: Aleksander
authors.initials: A
authors.lastname: Giwercman
authors.affiliation: Department of Endocrinology, Ashford and St Peter's NHS Foundation Trust, Chertsey, UK.
authors.forename: Thang S
authors.initials: TS
authors.lastname: Han
authors.affiliation: Department of Surgery and Cancer, Imperial College London, Hammersmith Campus, London, UK.
authors.forename: Ilpo T
authors.initials: IT
authors.lastname: Huhtaniemi
authors.affiliation: Department of Andrology and Reproductive Endocrinology, Medical University of Łódź, Łódź, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Kula
authors.affiliation: Department of Human Nutrition, University of Glasgow, Glasgow, UK.
authors.forename: Michael E J
authors.initials: MEJ
authors.lastname: Lean
authors.affiliation: Andrology Unit, United Laboratories of Tartu University Clinics, Tartu, Estonia.
authors.forename: Margus
authors.initials: M
authors.lastname: Punab
authors.affiliation: School of Social Sciences, Cathie Marsh Institute for Social Research, The University of Manchester, Manchester, UK.
authors.forename: David M
authors.initials: DM
authors.lastname: Lee
authors.affiliation: Andrology Research Unit, The University of Manchester, Manchester, UK.
authors.forename: Elon S
authors.initials: ES
authors.lastname: Correa
authors.affiliation: Andrology Research Unit, The University of Manchester, Manchester, UK.
authors.forename: Tomas
authors.initials: T
authors.lastname: Ahern
authors.affiliation: Gerontology and Geriatrics, Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium; Laboratory of Molecular Endocrinology, KU Leuven, Heverlee, Belgium.
authors.forename: Michaël R
authors.initials: MR
authors.lastname: Laurent
authors.affiliation: Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.
authors.forename: Sabine M P
authors.initials: SMP
authors.lastname: Verschueren
authors.affiliation: Department of Andrology and Endocrinology, KU Leuven, Leuven, Belgium; Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium.
authors.forename: Leen
authors.initials: L
authors.lastname: Antonio
authors.affiliation: Gerontology and Geriatrics, Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium; Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Evelien
authors.initials: E
authors.lastname: Gielen
authors.affiliation: The Endocrinology and Diabetes, Research Group, Faculty of Medical and Human Sciences, Institute of Human Development, University of Manchester, Manchester, UK; Manchester Diabetes Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
authors.forename: Martin K
authors.initials: MK
authors.lastname: Rutter
authors.affiliation: Department of Andrology and Endocrinology, KU Leuven, Leuven, Belgium.
authors.forename: Dirk
authors.initials: D
authors.lastname: Vanderschueren
authors.affiliation: Andrology Research Unit, The University of Manchester, Manchester, UK.
authors.forename: Frederick C W
authors.initials: FCW
authors.lastname: Wu
authors.affiliation: Gerontology and Geriatrics, Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium; Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Jos
authors.initials: J
authors.lastname: Tournoy
mesh_terms: D000328:Adult; D000368:Aged; D000375:Aging / Q000523:psychology*; D002097:C-Reactive Protein / Q000378:metabolism; D060825:Cognitive Dysfunction / Q000150:complications / Q000378:metabolism*; D015577:Geriatric Assessment; D006801:Humans; D006943:Hyperglycemia / Q000150:complications / Q000378:metabolism* / Q000523:psychology*; D007249:Inflammation / Q000150:complications / Q000378:metabolism; D008137:Longitudinal Studies; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000378:metabolism* / Q000523:psychology*; D008875:Middle Aged
chemical_list: D002097:C-Reactive Protein
keywords: Metabolic syndrome; aging; cognition; male health; multicenter study