Metabolic syndrome and dementia risk in a multiethnic elderly cohort

Background/Aims: The metabolic syndrome (MeSy) may be related to Alzheimer’s disease (AD). Our aims were to investigate the association of the MeSy with incident dementia in a multiethnic elderly cohort in the United States. Methods: We conducted cross-sectional and prospective analyses in 2,476 men and women aged 65 years and older and with data available on the MeSy and dementia diagnosis in Northern New York City. MeSy was defined by the National Cholesterol Education Program Adult Treatment Program III and the European Group for the Study of Insulin Resistance criteria. Dementia was diagnosed using standard criteria. Results: No association was found between MeSy and prevalent dementia. After 4.4 years of follow-up, 236 individuals of the 1,833 without prevalent dementia developed dementia. MeSy was not associated with incident dementia. Of the components of the MeSy, diabetes and hyperinsulinemia were associated with an increased risk of incident AD [hazard ratio 1.4 (95% CI 1.0–2.1), and hazard ratio 1.4 (95% CI 0.9–2.7), respectively] and dementia associated with stroke [hazard ratio 1.9 (95% CI 1.1–3.1), and hazard ratio 2.3 (95% CI 1.1–4.7), respectively]. Conclusions: The MeSy was not associated with an increased dementia risk in a multiethnic elderly cohort, but diabetes and hyperinsulinemia were. In the elderly, examining diabetes and hyperinsulinemia separately may be preferable to using the MeSy as a risk factor.

[1]  M. Folstein,et al.  Clinical diagnosis of Alzheimer's disease: Report of the NINCDS—ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease , 2011, Neurology.

[2]  R. Mayeux,et al.  Adiposity and Alzheimer's disease. , 2007, Current Alzheimer research.

[3]  R. Mayeux,et al.  Measures of Adiposity and Dementia Risk in the Elderly , 2006 .

[4]  J. Luchsinger.  A work in progress: the metabolic syndrome. , 2006, Science of aging knowledge environment : SAGE KE.

[5]  Seung-Hoon Lee,et al.  Metabolic syndrome as an independent risk factor of silent brain infarction in healthy people. , 2006, Stroke.

[6]  P. Scheltens,et al.  Risk of dementia in diabetes mellitus: a systematic review , 2006, The Lancet Neurology.

[7]  R. Krauss,et al.  Diagnosis and Management of the Metabolic Syndrome: An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement , 2005, Current opinion in cardiology.

[8]  D. Bennett,et al.  Change in body mass index and risk of incident Alzheimer disease , 2005, Neurology.

[9]  L S Honig,et al.  Aggregation of vascular risk factors and risk of incident Alzheimer disease , 2005, Neurology.

[10]  Kristine Yaffe,et al.  Obesity in middle age and future risk of dementia: a 27 year longitudinal population based study , 2005, BMJ : British Medical Journal.

[11]  R. Mayeux,et al.  Relationship Between Plasma Lipids and All‐Cause Mortality in Nondemented Elderly , 2005, Journal of the American Geriatrics Society.

[12]  R. Mayeux,et al.  Hyperinsulinemia and risk of Alzheimer disease , 2004, Neurology.

[13]  Richard Mayeux,et al.  Relation of plasma lipids to Alzheimer disease and vascular dementia. , 2004, Archives of neurology.

[14]  I. Skoog.  Highs and lows of blood pressure: a cause of Alzheimer's disease? , 2003, The Lancet Neurology.

[15]  R. Mayeux,et al.  The relationship of hypertension in the elderly to AD, vascular dementia, and cognitive function , 2002, Neurology.

[16]  Katsuhiko Yano,et al.  Age-related changes in risk factor effects on the incidence of coronary heart disease. , 2002, Annals of epidemiology.

[17]  R. Mayeux,et al.  Diabetes mellitus and risk of Alzheimer's disease and dementia with stroke in a multiethnic cohort. , 2001, American journal of epidemiology.

[18]  J Tuomilehto,et al.  Midlife vascular risk factors and Alzheimer's disease in later life: longitudinal, population based study , 2001, BMJ.

[19]  A. Hofman,et al.  Blood Pressure and Risk of Dementia: Results from the Rotterdam Study and the Gothenburg H-70 Study , 2000, Dementia and Geriatric Cognitive Disorders.

[20]  C M Burchfiel,et al.  Metabolic Cardiovascular Syndrome and Risk of Dementia in Japanese-American Elderly Men: The Honolulu-Asia Aging Study , 2000, Arteriosclerosis, thrombosis, and vascular biology.

[21]  R. Havlik,et al.  Midlife blood pressure and dementia: the Honolulu–Asia aging study☆ , 2000, Neurobiology of Aging.

[22]  A Alioum,et al.  Modelling age-specific risk: application to dementia. , 1998, Statistics in medicine.

[23]  A. Ott.  Risk of dementia: The Rotterdam Study , 1997 .

[24]  R. Mayeux,et al.  Diagnosis of dementia in a heterogeneous population. Development of a neuropsychological paradigm-based diagnosis of dementia and quantified correction for the effects of education. , 1992, Archives of neurology.

[25]  D. T. Vernier,et al.  Restriction isotyping of human apolipoprotein E by gene amplification and cleavage with HhaI. , 1990, Journal of lipid research.

[26]  C. P. Hughes,et al.  A New Clinical Scale for the Staging of Dementia , 1982, British Journal of Psychiatry.

[27]  R. Levy,et al.  Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. , 1972, Clinical chemistry.

[28]  C. Summerbell,et al.  Obesity in middle age and future risk of dementia , 2005 .

[29]  H. Minuk,et al.  Metabolic syndrome. , 2005, Journal of insurance medicine.

[30]  T. Harris,et al.  The metabolic syndrome, inflammation, and risk of cognitive decline. , 2004, JAMA.

[31]  P. McKeigue.  Ethnic Variation in Insulin Resistance and Risk of Type 2 Diabetes , 1999 .

[32]  K Clark,et al.  The effect of age on the association between body-mass index and mortality. , 1998, Journal of insurance medicine.

[33]  E. Feskens,et al.  Age-related changes in total and high-density-lipoprotein cholesterol in elderly Dutch men. , 1996, American journal of public health.