TY - JOUR
T1 - The metabolic syndrome in a memory clinic population
T2 - Relation with clinical profile and prognosis
AU - Exalto, Lieza G.
AU - Van Der Flier, Wiesje M.
AU - Van Boheemen, Caroline J M
AU - Kappelle, L. Jaap
AU - Vrenken, Hugo
AU - Teunissen, Charlotte
AU - Koene, Ted
AU - Scheltens, Phillip
AU - Biessels, Geert Jan
PY - 2015/1/1
Y1 - 2015/1/1
N2 - 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 3.4 years 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.
AB - 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 3.4 years 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.
KW - Atrophy
KW - Cerebrospinal fluid (CSF) biomarkers
KW - Cognitive performance
KW - Dementia
KW - Metabolic syndrome
KW - Progression
KW - Vascular lesions
UR - http://www.scopus.com/inward/record.url?scp=84926416216&partnerID=8YFLogxK
U2 - 10.1016/j.jns.2015.02.004
DO - 10.1016/j.jns.2015.02.004
M3 - Article
C2 - 25748296
AN - SCOPUS:84926416216
SN - 0022-510X
VL - 351
SP - 18
EP - 23
JO - Journal of the Neurological Sciences
JF - Journal of the Neurological Sciences
IS - 1-2
ER -