Cognitive impairment and frontal-subcortical geriatric syndrome are associated with metabolic syndrome in a stroke-free population.
ABSTRACT Metabolic syndrome (Met.S) consists of a conglomeration of obesity, hypertension, glucose intolerance, and dislipidemia. Frontal-subcortical geriatric syndrome (FSCS) is caused by ischemic disruption of the frontal-subcortical network. It is unknown if Met.S is associated with FSCS.
We evaluated 422 community-dwelling elderly (> or =60) in Brazil. FSCS was defined as the presence of at least one frontal release sign (grasping, palmomental, snout, or glabellar) plus coexistence of > or =3 the following criteria: (1) cognitive impairment, (2) late-onset depression, (3) neuromotor dysfunction, and (4) urgency incontinence. All values were adjusted to age and gender.
Met.S was present in 39.3% of all subjects. Cases without any of the FSCS components represented 37.2% ('successful neuroaging' group). People with 1-3 of the FSCS components ('borderline pathological neuroaging' group) were majority (52.6%), whereas those with 4-5 of these components (FSCS group) were minority (10.2%). Met.S was significantly associated with FSCS (OR=5.9; CI: 1.5-23.4) and cognitive impairment (OR=2.2; CI: 1.1-4.6) among stroke-free subjects. Number of Met.S components explained 30.7% of the variance on the number of FSCS criteria (P<0.001). If Met.S were theoretically removed from this population, prevalence of FSCS would decline by 31.6% and that of cognitive impairment by 21.4%.
Met.S was significantly associated with a 5.9 and 2.2 times higher chance of FSCS and cognitive impairment, respectively. Met.S might be a major determinant of 'successful' or 'pathological' neuroaging in western societies.
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ABSTRACT: Objective Aging is associated with a loss of cognitive performance and an increasing occurrence of cardio-vascular events. Moreover, cardio-vascular risk factors are linked to cognitive impairment and dementia. There is an increasing interest in the possible impact of vascular and metabolic disorders on cognitive functioning and dementia, and more generally in preventive strategies for limiting the occurrence of dementia. Whereas individual components of Metabolic Syndrome (Met S) have been reported to be linked to cognitive decline and dementia in many studies, there are very few studies on Met S as a whole. The present study aims to assess the relationship between Met S and its components and cognitive functioning in a cohort of elderly non-demented community residents. Methods: Design Population-based cohort study (PROOF study). Cross-sectional analysis. Participants Community-dwellers aged 65 years without dementia at recruitment. Main outcome measures The Proof participants underwent an extensive neuropsychological battery at baseline, exploring various cognitive functions. Summary measures of cognitive function including memory, attention and executive performance were created by converting the individual test results to Z scores and computing the average of the scores within each domain. Each of the three cognitive scores was individually compared between groups as a function of Met S, using a Pearson's Chi Square test or nonparametric tests if data were not normally distributed. The cognitive scores and the covariates which were significant in univariate analyses were then included in logistic regression models. Results A significant association was observed between the presence of metabolic syndrome, poor memory and executive function. This effect remained significant after adjusting for age, gender, education, tobacco use, anxiety, and depressive symptoms (memory: OR= 1.77, p=0.008; executive functions: OR=1.91, p=0.002). Conclusions Our study showed that in a sample of elderly non-demented community dwellers, metabolic syndrome was associated with poor memory performance and executive functioning. These results underline the importance of detecting and managing metabolic syndrome components in order to prevent cognitive impairment and dementia.The American journal of geriatric psychiatry: official journal of the American Association for Geriatric Psychiatry 01/2014; · 3.35 Impact Factor
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ABSTRACT: The present study examines cognitive function among transcription factor 7-like 2 (TCF7L2) genotype groups in a sample of older adults with cardiovascular disease. We recruited 111 older adults with diagnosed cardiovascular disease from outpatient cardiology clinics. Neuropsychological tests assessed the following domains of cognitive functioning: global function, attention/executive/psychomotor speed, learning and memory, visuospatial/construction, motor, and language. Genotyping of TCF7L2 single nucleotide polymorphism rs7903146 was conducted to determine membership in the TT, CT, or CC genotype groups. Controlling for diabetes status, participants with the TT genotype of TCF7L2 (n= 12) performed worse on tests of attention/executive function/processing speed than those with the CC (n= 46) and CT (n= 53) genotypes, despite no between-group differences in demographic or medical variables. Older cardiovascular disease patients with the TCF7L2 TT genotype performed worse on tests of attention/executive/ psychomotor speed than CC and CT genotype carriers. Further work using neuroimaging and glucose tolerance indices is needed to clarify underlying mechanisms.Psychogeriatrics 06/2012; 12(2):93-8. · 1.26 Impact Factor
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ABSTRACT: The prevalence of dementia varies substantially worldwide. This is partially attributed to the lack of methodological uniformity among studies, including diagnostic criteria and different mean population ages. However, even after considering these potential sources of bias, differences in age-adjusted dementia prevalence still exist among regions of the world. In Latin America, the prevalence of dementia is higher than expected for its level of population aging. This phenomenon occurs due to the combination of low average educational attainment and high vascular risk profile. Among developed countries, Japan seems to have the lowest prevalence of dementia. Studies that evaluated the immigration effect of the Japanese and blacks to USA evidenced that acculturation increases the relative proportion of AD cases compared to VaD. In the Middle East and Africa, the number of dementia cases will be expressive by 2040. In general, low educational background and other socioeconomic factors have been associated with high risk of obesity, sedentarism, diabetes, hypertension, dyslipidemia, and metabolic syndrome, all of which also raise the risk of VaD and AD. Regulating these factors is critical to generate the commitment to make dementia a public health priority.BioMed Research International 01/2014; 2014:908915. · 2.88 Impact Factor