The Metabolic Syndrome and Development of Cognitive Impairment Among Older Women
Open accessAbstract
BACKGROUND: Several studies support a role for cardiovascular risk factors in cognitive aging. The metabolic syndrome, a constellation of cardiovascular risk factors, is common in elderly people. A growing but conflicting body of literature suggests that the metabolic syndrome may be associated with cognitive impairment. OBJECTIVE: To investigate the association between the metabolic syndrome and its components and incident cognitive impairment in older women. DESIGN: We prospectively determined if the metabolic syndrome and its components were associated with a 4-year risk of developing cognitive impairment (dementia, mild cognitive impairment, or low global cognitive test score). SETTING: The study was conducted at 180 clinical centers in 25 countries. PARTICIPANTS: A total of 4895 older women (mean age, 66.2 years) with osteoporosis who were part of an ancillary study to determine clinically relevant cognitive impairment were included in this study. These women were free of baseline cognitive impairment and had metabolic syndrome component measures. MAIN OUTCOME MEASURES: Clinically significant cognitive impairment was defined to include women with clinically adjudicated dementia or MCI and women who had a Short Blessed test score greater than 6 (consistent with impairment), but whose cases were not clinically adjudicated. Logistic regression analysis was used to examine the association between presence of the metabolic syndrome and development of clinically significant cognitive impairment. RESULTS: A total of 497 women (10.2%) had the metabolic syndrome and, of these, 36 (7.2%) developed cognitive impairment compared with 181 (of 4398 or 4.1%) without the syndrome (age-adjusted odds ratio, 1.66; 95% confidence interval, 1.14-2.41). The mean (SD) number of metabolic syndrome components for all women was 1.0 (1.1); 518 women (10.6%) were obese, 895 (18.3%) had hypertriglyceridemia, 1200 (24.5%) had low high-density lipoprotein cholesterol levels, 1944 (39.7%) had high blood pressure, and 381 (7.8%) had high fasting blood glucose levels. There was a 23.0% age-adjusted increase in the risk of developing cognitive impairment (odds ratio, 1.23; 95% confidence interval, 1.09-1.39) per unit increase in the number of components. Further multivariable adjustment somewhat reduced the effect. CONCLUSION: We found an association between the metabolic syndrome and the number of components and risk of developing cognitive impairment in older women. Additional studies are needed to determine if screening and close management of these at-risk elderly women would diminish the incidence of cognitive impairment.
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Chronic hyperglycemia, increased insulin, metabolic syndrome, and diabetes are associated with VCI, VaD, or dementia with stroke.
“Chronic hyperglycemia, increased insulin, the metabolic syndrome, and diabetes are associated with VCI,337,345–348 as well as VaD or dementia with stroke.349,350”
From Vascular Contributions to Cognitive Impairment and Dementia: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association (2011) · cites this paper as [347]
The Comment and Results (pages unavailable) link metabolic syndrome and high fasting glucose to cognitive impairment in older women. They do not establish an association specifically with vascular cognitive impairment (VCI), and the paper does not report an association for increased insulin. The citing sentence assigns its separate claim about vascular dementia or dementia with stroke to other citations. (LLM, conf=0.85)
Experimental — accuracy not yet measuredLonger diabetes duration is associated with poorer cognitive function.
“Studies suggest that the longer the duration of diabetes, the poorer the cognitive function.347,348,352”
From Vascular Contributions to Cognitive Impairment and Dementia: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association (2011) · cites this paper as [347]
The Introduction (page unavailable) says diabetes mellitus has been related to cognitive decline and dementia risk. But neither that passage nor the study’s findings in the Comment (page unavailable) address whether longer diabetes duration is associated with poorer cognitive function; searches for diabetes duration found no such result. (LLM, conf=0.82)
Experimental — accuracy not yet measuredHigh fasting glucose or diabetes mellitus is associated with cognitive impairment and dementia.
“For example, having high fasting glucose or diabetes mellitus has been associated with cognitive impairment and dementia.63–65”
From Defining Optimal Brain Health in Adults: A Presidential Advisory From the American Heart Association/American Stroke Association (2017) · cites this paper as [63]
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Cites
Grundy, S. M., Bilheimer, D. W., Chait, A., Clark, L. T., Denke, M. A., Havel, R. J., Hazzard, W. R., Hulley, S. B., Hunninghake, D. B., Kreisberg, R. A., et al. (1993) · JAMA · doi:10.1001/jama.269.23.3015 · Cited by 27,944 · see citing works
McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D., & Stadlan, E. M. (1984) · Neurology · doi:10.1212/wnl.34.7.939 · Cited by 27,915 · see citing works
Expert Panel on Detection, E. (2001) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.285.19.2486 · Cited by 26,011 · see citing works
McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D. L., & Stadlan, E. (2011) · Neurology · doi:10.1212/01.wnl.0000400650.92875.cf · Cited by 9,882 · see citing works
Mild Cognitive Impairment: Clinical Characterization and Outcome
Petersen, R. C., Smith, G. E., Waring, S. C., Ivnik, R. J., Tangalos, E. G., & Kokmen, E. (1999) · Archives of Neurology · doi:10.1001/archneur.56.3.303 · Cited by 8,980 · see citing works
Sheikh (1986) · doi:10.1300/j018v05n01_09 · Cited by 7,236 · see citing works
Ford, E. S., Giles, W. H., & Dietz, W. H. (2002) · JAMA · doi:10.1001/jama.287.3.356 · Cited by 6,698 · see citing works
Alzheimer Disease in the US Population: Prevalence Estimates Using the 2000 Census
Hebert, L. E., Scherr, P. A., Bienias, J. L., Bennett, D. A., & Evans, D. A. (2003) · Archives of Neurology · doi:10.1001/archneur.60.8.1119 · Cited by 2,168 · see citing works
Validation of a short Orientation-Memory-Concentration Test of cognitive impairment
Katzman, R., Brown, T., Fuld, P. A., Peck, A., Schechter, R., & Schimmel, H. (1983) · American Journal of Psychiatry · doi:10.1176/ajp.140.6.734 · Cited by 2,119 · see citing works
Obesity and Vascular Risk Factors at Midlife and the Risk of Dementia and Alzheimer Disease
Kivipelto, M., Ngandu, T., Fratiglioni, L., Viitanen, M., Kåreholt, I., Winblad, B., Helkala, E.-L., Tuomilehto, J., Soininen, H., & Nissinen, A. (2005) · Archives of Neurology · doi:10.1001/archneur.62.10.1556 · Cited by 1,291 · see citing works
The age-dependent relation of blood pressure to cognitive function and dementia
Qiu, C., Winblad, B., & Fratiglioni, L. (2005) · The Lancet Neurology · doi:10.1016/s1474-4422(05)70141-1 · Cited by 1,138 · see citing works
Obesity in middle age and future risk of dementia: a 27 year longitudinal population based study
Whitmer, R. A., Gunderson, E. P., Barrett-Connor, E., Quesenberry, C. P., & Yaffe, K. (2005) · BMJ · doi:10.1136/bmj.38446.466238.e0 · Cited by 1,090 · see citing works
Self-citationThe metabolic syndrome, inflammation, and risk of cognitive decline
Yaffe, K. (2004) · JAMA · doi:10.1001/jama.292.18.2237 · Cited by 1,025 · see citing works
Self-citationMidlife blood pressure and dementia: the Honolulu–Asia aging study☆
Launer, L. J., Ross, G. W., Petrovitch, H., Masaki, K., Foley, D., White, L. R., & Havlik, R. J. (2000) · Neurobiology of Aging · doi:10.1016/s0197-4580(00)00096-8 · Cited by 1,008 · see citing works
Cardiovascular risk factors and cognitive decline in middle-aged adults
Knopman, D., Boland, L. L., Mosley, T., Howard, G., Liao, D., Szklo, M., McGovern, P., & Folsom, A. R. (2001) · Neurology · doi:10.1212/wnl.56.1.42 · Cited by 883 · see citing works
Dalton, M., Cameron, A. J., Zimmet, P., Shaw, J. E., Jolley, D., Dunstan, D. W., & Welborn, T. A. (2003) · Journal of Internal Medicine · doi:10.1111/j.1365-2796.2003.01229.x · Cited by 666 · see citing works
Diabetes, impaired fasting glucose, and development of cognitive impairment in older women
Yaffe, K., Blackwell, T., Kanaya, A. M., Davidowitz, N., Barrett-Connor, E., & Krueger, K. (2004) · Neurology · doi:10.1212/01.wnl.0000134666.64593.ba · Cited by 520 · see citing works
Self-citationGasparini, L., Gouras, G. K., Wang, R., Gross, R. S., Beal, M. F., Greengard, P., & Xu, H. (2001) · Journal of Neuroscience · doi:10.1523/jneurosci.21-08-02561.2001 · Cited by 493 · see citing works
Craft, S. (2007) · Current Alzheimer Research · doi:10.2174/156720507780362137 · Cited by 487 · see citing works
Incidence and Risk of Dementia: The Rotterdam study
Ott, A., Breteler, M. M. B., Harskamp, F. V., Stijnen, T., & Hofman, A. (1998) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a009489 · Cited by 455 · see citing works
Serum Lipoprotein Levels, Statin Use, and Cognitive Function in Older Women
Yaffe, K. S., Barrett-Connor, E. L., Lin, F., & Grady, D. G. (2002) · Archives of Neurology · doi:10.1001/archneur.59.3.378 · Cited by 439 · see citing works
Self-citationKalmijn, S., Foley, D., White, L., Burchfiel, C. M., Curb, J. D., Petrovitch, H., Ross, G. W., Havlik, R. J., & Launer, L. J. (2000) · Arteriosclerosis, Thrombosis, and Vascular Biology · doi:10.1161/01.atv.20.10.2255 · Cited by 417 · see citing works
Central Obesity and the Aging Brain
Jagust, W. J., Harvey, D. J., Mungas, D., & Haan, M. N. (2005) · Archives of Neurology · doi:10.1001/archneur.62.10.1545 · Cited by 314 · see citing works
Association of metabolic syndrome with Alzheimer disease
Vanhanen, M., Koivisto, K. J., Moilanen, L., Helkala, E.-L., Hänninen, T., Soininen, H. S., Kervinen, K., Kesäniemi, Y. A., Laakso, M., & Kuusisto, J. (2006) · Neurology · doi:10.1212/01.wnl.0000234037.91185.99 · Cited by 295 · see citing works
Vascular Risk Factors for Incident Alzheimer Disease and Vascular Dementia: The Cache County Study
Hayden, K. M., Zandi, P. P., Lyketsos, C. G., Khachaturian, A. S., Bastian, L. A., Charoonruk, G., Tschanz, J. T., Norton, M. C., Pieper, C. F., Munger, R. G., et al. (2006) · Alzheimer Disease & Associated Disorders · doi:10.1097/01.wad.0000213814.43047.86 · Cited by 293 · see citing works
Diabetes Mellitus and Risk of Developing Alzheimer Disease
Akomolafe, A., Beiser, A., Meigs, J. B., Au, R., Green, R. C., Farrer, L. A., Wolf, P. A., & Seshadri, S. S. (2006) · Archives of Neurology · doi:10.1001/archneur.63.11.1551 · Cited by 281 · see citing works
The Metabolic Syndrome and Alzheimer Disease
Razay, G., Vreugdenhil, A., & Wilcock, G. K. (2007) · Archives of Neurology · doi:10.1001/archneur.64.1.93 · Cited by 269 · see citing works
Contribution of Metabolic Syndrome Components to Cognition in Older Individuals
Dik, M. G., Jonker, C., Comijs, H. C., Deeg, D. J. H., Kok, A., Yaffe, K. S., & Penninx, B. W. J. H. (2007) · Diabetes Care · doi:10.2337/dc06-1190 · Cited by 258 · see citing works
Self-citationDemonstrating the case that AD is a vascular disease: epidemiologic evidence
Launer, L. J. (2002) · Ageing Research Reviews · doi:10.1016/s0047-6374(01)00364-5 · Cited by 227 · see citing works
Yaffe, K. S., Krueger, K. A., Cummings, S. R., BLACKWELL, T. L., Henderson, V. W., Sarkar, S., Ensrud, K. E., & Grady, D. G. (2005) · American Journal of Psychiatry · doi:10.1176/appi.ajp.162.4.683 · Cited by 212 · see citing works
Self-citationYaffe, K. S., Haan, M. N., BLACKWELL, T. L., Cherkasova, E., Whitmer, R. A., & West, N. A. (2007) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2007.01139.x · Cited by 210 · see citing works
Self-citationThe metabolic syndrome is associated with decelerated cognitive decline in the oldest old
van den Berg, E., Biessels, G. J., de Craen, A. J. M., Gussekloo, J., & Westendorp, R. G. J. (2007) · Neurology · doi:10.1212/01.wnl.0000271381.30143.75 · Cited by 193 · see citing works
Metabolic Syndrome and Cognitive Disorders
Yaffe, K. S. (2007) · Alzheimer Disease & Associated Disorders · doi:10.1097/wad.0b013e318065bfd6 · Cited by 186 · see citing works
Self-citationMetabolic syndrome and dementia risk in a multiethnic elderly cohort
Muller, M., Tang, M.-X., Schupf, N., Manly, J. J., Mayeux, R., & Luchsinger, J. A. (2007) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000105927 · Cited by 175 · see citing works
Asomaning, K., Bertone‐Johnson, E. R., Nasca, P. C., Hooven, F. H., & Pekow, P. S. (2006) · Journal of Women s Health · doi:10.1089/jwh.2006.15.1028 · Cited by 170 · see citing works
Ettinger, B. B., Black, D. M., Mitlak, B., et al. (2000) · Obstetrical & Gynecological Survey · doi:10.1097/00006254-200001000-00021 · Cited by 170 · see citing works
Blessed-Roth Dementia Scale (DS).
Blessed, G., Be, T., & Roth, M. (1988) · PubMed · Cited by 76 · see citing works
The metabolic syndrome, inflammation, and risk of cognitive decline
Yaffe, K. S., Kanaya, A. M., & Lindquist, K. J. (2005) · ACC Current Journal Review · doi:10.1016/j.accreview.2004.12.135 · Cited by 57 · see citing works
Self-citationLawlor, D. A., Ebrahim, S. B. J., & Smith, G. D. (2004) · Diabetic Medicine · doi:10.1111/j.1464-5491.2004.01245.x · Cited by 50 · see citing works
Metabolic syndrome and dementia risk in a multiethnic elderly cohort
Muller, M., Tang, M. ‐., Schupf, N., et al. (2009) · Journal of the Neurological Sciences · doi:10.1016/j.jns.2009.02.257 · Cited by 8 · see citing works
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Gorelick, P. B., Scuteri, A., Black, S. E., DeCarli, C., Greenberg, S. M., Iadecola, C., Launer, L. J., Laurent, S., Lopez, O. L., Nyenhuis, D., et al. (2011) · Stroke · doi:10.1161/str.0b013e3182299496 · Cited by 3,811 · see citing works
Epidemiology of Alzheimer disease
Reitz, C., Brayne, C., & Mayeux, R. (2011) · Nature Reviews Neurology · doi:10.1038/nrneurol.2011.2 · Cited by 1,675 · see citing works
Gorelick, P. B., Furie, K. L., Iadecola, C., Smith, E. E., Waddy, S. P., Lloyd-Jones, D. M., Bae, H.-J., Bauman, M. A., Dichgans, M., Duncan, P. W., et al. (2017) · Stroke · doi:10.1161/str.0000000000000148 · Cited by 411 · see citing works
Self-citationGorelick, P. B. (2010) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.2010.05726.x · Cited by 361 · see citing works
Juster, R.-P., Bizik, G., Picard, M., Arsenault-Lapierre, G., Sindi, S., Trepanier, L., Marin, M.-F., Wan, N., Sekerovic, Z., Lord, C., et al. (2011) · Development and Psychopathology · doi:10.1017/s0954579411000289 · Cited by 268 · see citing works
Neuroinflammation and Cognitive Aging
Ownby, R. L. (2010) · Current Psychiatry Reports · doi:10.1007/s11920-009-0082-1 · Cited by 212 · see citing works
Cardiovascular Disease Risk Factors and Cognition in the Elderly
Leritz, E. C., McGlinchey, R. E., Kellison, I., Rudolph, J. L., & Milberg, W. P. (2011) · Current Cardiovascular Risk Reports · doi:10.1007/s12170-011-0189-x · Cited by 188 · see citing works
Type 2 diabetes mellitus, dyslipidemia, and Alzheimer’s disease
Carlsson, C. M. (2010) · Journal of Alzheimer s Disease · doi:10.3233/jad-2010-100012 · Cited by 109 · see citing works
Nilsson, A., Radeborg, K., Salo, I., & Björck, I. (2012) · Nutrition Journal · doi:10.1186/1475-2891-11-99 · Cited by 86 · see citing works
McIntyre, R. S., Alsuwaidan, M., Goldstein, B. I., Taylor, V. H., Schaffer, A., Beaulieu, S., & Kemp, D. E. (2012) · Annals of Clinical Psychiatry · doi:10.1177/104012371202400108 · Cited by 45 · see citing works
- Authors
- Yaffe, K., Weston, A. L., Blackwell, T., & Krueger, K. A.
- Affiliations
- San Francisco VA Medical Center (US)
- Venue
- Archives of Neurology
- Publisher
- American Medical Association (AMA)
- Published
- 2009-03-01
- Volume
- 66
- Issue
- 3
- Pages
- 324-8
- ISSN
- 0003-9942 (ISSN-L)
- PMC
- PMC2685462
- OpenAlex
- W2008367735
- Cited by
- 220
- References
- 41
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 6 · 2023: 5 · 2022: 5 · 2021: 14 · 2020: 6 · 2019: 8 · 2018: 6 · 2017: 11 · 2016: 12 · 2015: 17 · 2014: 16 · 2013: 16 · 2012: 27
- FWCI
- 17.73
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Archives of Neurology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Aging (AG031155, K24AG031155)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- metabolic syndrome, cognitive impairment, dementia, mild cognitive impairment, older women, cardiovascular risk factors, hypertriglyceridemia, low HDL cholesterol, hypertension, obesity, fasting blood glucose, cognitive aging, osteoporosis, incident risk, number of metabolic syndrome components, cardiovascular disease prevention, Alzheimer's disease prevention
- MeSH terms
- Aged, Cognition Disorders, Female, Humans, Longitudinal Studies, Middle Aged, Risk Factors, Likelihood Functions, Odds Ratio, Statistics, Nonparametric, Metabolic Syndrome
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