Objective The authors investigated the relationship of metabolic syndrome (MetS) and its individual components with incident dementia in a prospective population-based study with a 3.5-year follow-up.
Methods A total of 2097 participants from a sample of 5632 subjects (65–84 years old) from the Italian Longitudinal Study on Ageing were evaluated. MetS was defined according to the Third Adults Treatment Panel of the National Cholesterol Education Program criteria. Dementia, Alzheimer disease (AD) and vascular dementia (VaD) were classified using current published criteria.
Results MetS subjects (N=918) compared with those without MetS (N=1179) had an increased risk for VaD (1.63% vs 0.85%, adjusted hazard ratio (HR) 3.71, 95% CI 1.40 to 9.83). After excluding 338 subjects with baseline undernutrition, MetS subjects compared with those without MetS had an elevated risk of VaD (adjusted HR, 3.82; 95% CI 1.32 to 11.06). Moreover, those with MetS and high inflammation had a still further higher risk of VaD (multivariate adjusted HR, 9.55; 95% CI 1.17 to 78.17) compared with those without MetS and high inflammation. On the other hand, those with MetS and low inflammation compared with those without MetS and low inflammation did not exhibit a significant increased risk of VaD (adjusted HR, 3.31, 95% CI 0.91 to 12.14). Finally, a synergistic MetS effect versus its individual component effects was verified on the risk of VaD.
Conclusion In our population, MetS subjects had an elevated risk of VaD that increased after excluding patients with baseline undernutrition and selecting MetS subjects with high inflammation.
- Alzheimer disease
- metabolic disease
- vascular dementia
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Funding This work was supported by the Italian Longitudinal Study on Ageing (ILSA) (Italian National Research Council—CNR-Targeted Project on Ageing—Grants 9400419PF40 and 95973PF40) (VS, ES, CC, AD'I, AMC, MB, GC, ADC, LG, CG, DI, SM, AC and FP).
Competing interests None.
Ethics approval Ethics approval was provided by the regional medical school ethics committees.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.
The ILSA Working Group E Scafato (Scientific Coordinator), G Farchi, L Galluzzo, C Gandin, Istituto Superiore di Sanità, Rome; A Capurso, F Panza, V Solfrizzi, V Lepore, P Livrea, University of Bari; L Motta, G Carnazzo, M Motta, P Bentivegna, University of Catania; S Bonaiuto, G Cruciani, D Postacchini, Italian National Research Centre on Ageing (INRCA), Fermo; D Inzitari, L Amaducci, University of Florence; A Di Carlo, M Baldereschi, Italian National Research Council (CNR), Firenze; C Gandolfo, M Conti, University of Genoa; N Canal, M Franceschi, San Raffaele Institute, Milan; G Scarlato, L Candelise, E Scapini, University of Milan; F Rengo, P Abete, F Cacciatore, University of Naples; G Enzi, L Battistin, G Sergi, G Crepaldi, University of Padua; S Maggi, N Minicucci, M Noale, Italian National Research Council (CNR), Ageing Section, Padua; F Grigoletto, E Perissinotto, Institute of Hygiene, University of Padua; P Carbonin, Università Cattolica del Sacro Cuore, Rome.