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Associations of the metabolic syndrome and its components with cognitive impairment in older adults.

ABSTRACT: BACKGROUND:The metabolic syndrome (MetS) is an established cardiovascular risk factor. Here, we investigated its role in cognitive impairment. METHODS:Baseline data from 202 participants (aged 65 to 87?years) of the BioCog study were used. All were free of clinical dementia (MMSE?24/30). Cognitive impairment was defined as the lowest tertile of a cognitive summary score. Multiple logistic regression analyses examined associations of body mass index (BMI), triglycerides (TG), high-density lipoprotein (HDL-C), glucose and glycated hemoglobin A1c (HbA1c) levels with the odds of cognitive impairment. MetS was defined as ?3 of its 5 components obesity (BMI???30?kg/m2), elevated TG (TG ?1.7?mmol/L), reduced HDL-C (males: ?0.05). Results for HDL-C were similar when HDL-C, glucose, BMI and TG were entered into a single model (OR 2.56 per 1?mmol/L reduction, 95% CI 1.09, 5.88, p?=?0.031) and when cerebrovascular disease and coronary heart disease were additionally controlled for (OR 2.56 per 1?mmol/L reduction, 95% CI 1.06, 6.25, p?=?0.036). Among the 5 MetS components, participants with elevated TG were at 2-fold increased odds of impairment (OR 2.09, 95% CI 1.08, 4.05, p?=?0.028) including when the remaining 4 MetS components were entered (OR 2.23, 95% CI 1.07, 4.65, p?=?0.033), but the finding was no longer statistically significant when cerebrovascular disease and coronary heart disease were additionally controlled for (p?=?0.11). Presence of MetS and of obesity, reduced HDL-C, elevated glucose or elevated blood pressure were not significantly associated with impairment (all p?>?0.05). CONCLUSION:Our findings support low HDL-C as an independent risk marker of cognitive impairment in older age. The need for research into mediatory and confounding factors, and re-evaluation of traditional cut-off points is highlighted. TRIAL REGISTRATION:The study was registered on 15th October 2014 at clinicaltrials.gov ( NCT02265263 ).

SUBMITTER: Feinkohl I

PROVIDER: S-EPMC6407250 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature

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Associations of the metabolic syndrome and its components with cognitive impairment in older adults.

Feinkohl Insa I Janke Jürgen J Hadzidiakos Daniel D Slooter Arjen A Winterer Georg G Spies Claudia C Pischon Tobias T

BMC geriatrics 20190307 1

<h4>Background</h4>The metabolic syndrome (MetS) is an established cardiovascular risk factor. Here, we investigated its role in cognitive impairment.<h4>Methods</h4>Baseline data from 202 participants (aged 65 to 87 years) of the BioCog study were used. All were free of clinical dementia (MMSE≥24/30). Cognitive impairment was defined as the lowest tertile of a cognitive summary score. Multiple logistic regression analyses examined associations of body mass index (BMI), triglycerides (TG), high- ...[more]

PMID: 30845934

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Project description:Objective: The aim of this study was to explore the longitudinal associations of stroke with cognitive impairment in older US adults. Method: The data used in this longitudinal analysis were extracted from the National Health and Aging Trends Study (NHATS) from 2011 to 2019. Univariate and multivariable Cox proportional hazards regression models were used to estimate the longitudinal association of stroke with cognitive impairment. The multivariable model was adjusted by demographic, physical, and mental characteristics, and the complex survey design of NHATS was taken into consideration. Results: A total of 7,052 participants with complete data were included. At the baseline, the weighted proportion of cognitive impairment was 19.37% (95% CI, 17.92-20.81%), and the weighted proportion of the history of stroke was 9.81% (95% CI, 8.90-10.72%). In univariate analysis, baseline stroke history was significantly associated with cognitive impairment in the future (hazard ratio, 1.746; 95% CI, 1.461-2.088), and the baseline cognitive impairment was significantly associated with future report of stroke (hazard ratio, 1.436; 95% CI, 1.088-1.896). In multivariable model, stroke was also significantly associated with cognitive impairment (hazard ratio, 1.241; 95% CI, 1.011-1.522); however, the reverse association was not significant (hazard ratio, 1.068; 95% CI, 0.788-1.447). After the data from proxy respondents were excluded, in the sensitive analyses, the results remained unchanged. Conclusion: Older adults in the United States who suffered strokes are more likely to develop cognitive impairment as a result in the future than those who have not had strokes. However, the reverse association did not hold. Furthermore, the study suggests that it is necessary to screen and take early intervention for cognitive impairment in stroke survivors and prevent the incidence of stroke by modifying risk factors in the general population with rapidly growing older US adults.

Project description:Higher levels of optimism have been linked with positive health behaviors, biological processes, and health conditions that are potentially protective against cognitive impairment in older adults. However, the association between optimism and cognitive impairment has not been directly investigated. We examined whether optimism is associated with incident cognitive impairment in older adults.Data are from the Health and Retirement Study. Optimism was measured by using the Life Orientation Test-R and cognitive impairment with a modified version of the Telephone Interview for Cognitive Status derived from the Mini-Mental State Examination. Using multiple logistic regression models, we prospectively assessed whether optimism was associated with incident cognitive impairment in 4624 adults 65 years and older during a 4-year period.Among participants, 312 women and 190 men developed cognitive impairment during the 4-year follow-up. Higher optimism was associated with decreased risk of incident cognitive impairment. When adjusted for sociodemographic factors, each standard deviation increase in optimism was associated with reduced odds (odds ratio [OR] = 0.70, 95% confidence interval [CI] = 0.61-0.81) of becoming cognitively impaired. A dose-response relationship was observed. Compared with those with the lowest levels of optimism, people with moderate levels had somewhat reduced odds of cognitive impairment (OR = 0.78, 95% CI = 0.59-1.03), whereas people with the highest levels had the lowest odds of cognitive impairment (OR = 0.52, 95% CI = 0.36-0.74). These associations remained after adjusting for health behaviors, biological factors, and psychological covariates that could either confound the association of interest or serve on the pathway.Optimism was prospectively associated with a reduced likelihood of becoming cognitively impaired. If these results are replicated, the data suggest that potentially modifiable aspects of positive psychological functioning such as optimism play an important role in maintaining cognitive functioning.

Dataset Information

Associations of the metabolic syndrome and its components with cognitive impairment in older adults.

Publications

Associations of the metabolic syndrome and its components with cognitive impairment in older adults.

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