Lieza G Exalto1, Wiesje M van der Flier2, Caroline J M van Boheemen3, L Jaap Kappelle4, Hugo Vrenken5, Charlotte Teunissen6, Ted Koene7, Phillip Scheltens8, Geert Jan Biessels4. 1. Department of Neurology, Brain Centre Rudolf Magnus Institute, University Medical Centre Utrecht, Utrecht, The Netherlands; Alzheimer Centre, VU University Medical Centre, Amsterdam, The Netherlands. Electronic address: l.g.exalto-2@umcutrecht.nl. 2. Department of Epidemiology and Biostatistics, VU University, Amsterdam, The Netherlands; Alzheimer Centre, VU University Medical Centre, Amsterdam, The Netherlands. 3. Department of Neurology, Medical Centre Haaglanden, The Hague, The Netherlands. 4. Department of Neurology, Brain Centre Rudolf Magnus Institute, University Medical Centre Utrecht, Utrecht, The Netherlands. 5. Department of Radiology, VU University Medical Centre, Amsterdam, The Netherlands; Department of Physics and Medical Technology, VU University Medical Centre, Amsterdam, The Netherlands; Alzheimer Centre, VU University Medical Centre, Amsterdam, The Netherlands. 6. Neurochemistry Lab and Biobank, Department of Clinical Chemistry, VU University Medical Centre, Amsterdam, The Netherlands; Alzheimer Centre, VU University Medical Centre, Amsterdam, The Netherlands. 7. Department of Medical Psychology, VU University Medical Centre, Amsterdam, The Netherlands; Alzheimer Centre, VU University Medical Centre, Amsterdam, The Netherlands. 8. Department of Neurology, VU University Medical Centre, Amsterdam, The Netherlands; Alzheimer Centre, VU University Medical Centre, Amsterdam, The Netherlands.
Abstract
BACKGROUND: The metabolic syndrome (MetS) refers to a cluster of cardiovascular risk factors that is associated with an increased risk of cognitive impairment and dementia. It is unclear however, if the presence of the MetS is associated with a particular clinical profile or a different prognosis in patients with cognitive complaints or early dementia. OBJECTIVES: To compare 1) the clinical profile and 2) the prognosis of patients attending a memory clinic according to the presence or absence of MetS. DESIGN: Longitudinal cohort. SETTING: Memory clinic. PARTICIPANTS: We included and followed 86 consecutive patients (average age of 66.7 (SD 9.7)) from the Amsterdam Dementia Cohort with an MMSE>22. MEASUREMENTS: Clinical profile (neuropsychological examination, brain MRI, cerebrospinal fluid (CSF) biomarkers, clinical diagnosis) on an initial standardized diagnostic assessment was compared according to MetS status. Progression to dementia was assessed in initially nondemented patients (subjective complaints n=40, mild cognitive impairment n=24, follow-up available in 59). RESULTS: 35 (41%) patients met the MetS criteria. Demographics were similar between patients with or without the MetS. At baseline, diagnosis, cognitive performance, severity of degenerative or vascular abnormalities on MRI, and CSF amyloid and tau levels did not differ between the groups (all p>0.05). Among nondemented patients, however, MetS was associated with worse performance on executive function, attention & speed and visuoconstructive ability (z-scores, p<0.05). During a mean follow-up of 3.4years a similar proportion of patients with (4; 17%) and without (6; 17%) the MetS progressed to dementia (p=0.45). CONCLUSION: Among nondemented patients presenting at a memory clinic MetS was associated with slightly worse cognitive performance (worse on tasks assessing executive functions, visuo-constructive ability, attention & speed), but conversion rate to dementia was not increased.
BACKGROUND: The metabolic syndrome (MetS) refers to a cluster of cardiovascular risk factors that is associated with an increased risk of cognitive impairment and dementia. It is unclear however, if the presence of the MetS is associated with a particular clinical profile or a different prognosis in patients with cognitive complaints or early dementia. OBJECTIVES: To compare 1) the clinical profile and 2) the prognosis of patients attending a memory clinic according to the presence or absence of MetS. DESIGN: Longitudinal cohort. SETTING: Memory clinic. PARTICIPANTS: We included and followed 86 consecutive patients (average age of 66.7 (SD 9.7)) from the Amsterdam Dementia Cohort with an MMSE>22. MEASUREMENTS: Clinical profile (neuropsychological examination, brain MRI, cerebrospinal fluid (CSF) biomarkers, clinical diagnosis) on an initial standardized diagnostic assessment was compared according to MetS status. Progression to dementia was assessed in initially nondemented patients (subjective complaints n=40, mild cognitive impairment n=24, follow-up available in 59). RESULTS: 35 (41%) patients met the MetS criteria. Demographics were similar between patients with or without the MetS. At baseline, diagnosis, cognitive performance, severity of degenerative or vascular abnormalities on MRI, and CSF amyloid and tau levels did not differ between the groups (all p>0.05). Among nondemented patients, however, MetS was associated with worse performance on executive function, attention & speed and visuoconstructive ability (z-scores, p<0.05). During a mean follow-up of 3.4years a similar proportion of patients with (4; 17%) and without (6; 17%) the MetS progressed to dementia (p=0.45). CONCLUSION: Among nondemented patients presenting at a memory clinic MetS was associated with slightly worse cognitive performance (worse on tasks assessing executive functions, visuo-constructive ability, attention & speed), but conversion rate to dementia was not increased.
Authors: Bronwen Martin; Rui Wang; Wei-Na Cong; Caitlin M Daimon; Wells W Wu; Bin Ni; Kevin G Becker; Elin Lehrmann; William H Wood; Yongqing Zhang; Harmonie Etienne; Jaana van Gastel; Abdelkrim Azmi; Jonathan Janssens; Stuart Maudsley Journal: J Biol Chem Date: 2017-05-18 Impact factor: 5.157
Authors: Debomoy K Lahiri; Bryan Maloney; Baindu L Bayon; Nipun Chopra; Fletcher A White; Nigel H Greig; John I Nurnberger Journal: Epigenomics Date: 2016-03-07 Impact factor: 4.778
Authors: Gabriela Gomez; Lori L Beason-Held; Murat Bilgel; Yang An; Dean F Wong; Stephanie Studenski; Luigi Ferrucci; Susan M Resnick Journal: J Alzheimers Dis Date: 2018 Impact factor: 4.472
Authors: Whitney Wharton; Felicia C Goldstein; Malú G Tansey; Alexandra L Brown; Sonum D Tharwani; Danielle D Verble; Amarallys Cintron; Patrick G Kehoe Journal: J Alzheimers Dis Date: 2018 Impact factor: 4.472
Authors: Insa Feinkohl; Gunnar Lachmann; Tobias Pischon; Claudia Spies; Wolf-Rüdiger Brockhaus; Friedrich Borchers; Sophie K Piper; Thomas H Ottens; Hendrik M Nathoe; Anne-Mette Sauer; Jan M Dieleman; Finn M Radtke; Diederik van Dijk Journal: Clin Epidemiol Date: 2018-07-25 Impact factor: 4.790