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Midlife metabolic syndrome and neurocognitive function in a mixed Asian sample

  • Simon L. Collinson (a1), Sandy J. F. Tong (a2), Sarah S. K. Loh (a1), S. B. Chionh (a2) and Reshma A. Merchant (a2)...

Abstract

Background:

An association between metabolic syndrome (MetS) and disturbances in neurocognitive function has been identified in Caucasians but the nature and extent of impaired cognition in Asian MetS patients, who may be at greater risk of degenerative cognitive decline, remains unspecified.

Methods:

A cross-sectional study was conducted at the National University Hospital of Singapore. Participants were recruited from a diabetes clinic at the National University Hospital. Fifty-three patients who met MetS criteria and 44 clinical controls were recruited. All participants were 55 years and above and community ambulant. Neurocognitive function was assessed using the Cambridge Neuropsychological Test Automated Battery (CANTAB). CANTAB performances between MetS and control groups were examined with analysis of variance (ANOVA) and the relative contributions of vascular risk, and intrademographic factors on CANTAB scores were dilineated with stepwise regression analyses.

Results:

Participants with MetS consistently performed significantly worse than controls across all CANTAB subtests. Education and Chinese race were found to be potential protective factors.

Conclusions:

Executive and memory impairment is present in Asian patients with midlife MetS who may be particularly vulnerable to the detrimental impact of MetS in midlife.

Copyright

Corresponding author

Correspondence should be addressed to: Dr. Simon L. Collinson, Department of Psychology, National University of Singapore, Block AS4, #02-07, 9 Arts Link, Singapore 117570, Singapore. Phone: +65-65168117. Email: psycsl@nus.edu.sg.

References

Hide All
Alberti, K. G., Zimmet, P. and Shaw, J. (2005). IDF epidemiology task force consensus group. The metabolic syndrome – a new worldwide definition. Lancet, 366, 10591062.
Basit, A. and Shera, A. S. (2008). Prevalence of metabolic syndrome in Pakistan. Metabolic Syndrome and Related Disorders, 6, 171175.
Blair, C. K., Folsom, A. R., Knopman, D. S., Bray, M. S., Mosley, T. H. and Boerwinkle, E. (2005). APOE genotype and cognitive decline in a middle-aged cohort. Neurology, 64, 268276.
Carmelli, D. et al. (1998). Midlife cardiovascular risk factors, ApoE, and cognitive decline in elderly male twins. Neurology, 50, 15801585.
Debette, S. and Seshadri, S. (2009). Vascular risk factors and dementia revisited. Journal of Neurology, Neurosurgery, and Psychiatry, 80, 11831184.
de Jager, C. A., Milwain, E. and Budge, M. (2002). Early detection of isolated memory deficits in the elderly: the need for more sensitive neuropsychological tests. Psychological Medicine, 32, 483491.
Deurenberg-Yap, M., Chew, S. K., Lin, V. F. P., Tan, B. Y., van Staveren, W. A. and Deurenberg, P. (2001). Relationships between indices of obesity and its co-morbidities in multi-ethnic Singapore. International Journal of Obesity, 25, 15541562.
Dik, M. G. et al. (2007). Contribution of metabolic syndrome components to cognition in older individuals. Diabetes Care, 30, 26552660.
Elias, M. F., Wolf, P. A., D’Agostino, R. B., Cobb, J. and White, L. R. (1993). Untreated blood pressure level is inversely related to cognitive functioning: the Framingham study. American Journal of Epidemiology, 138, 353364.
Enzinger, C. et al. (2005) Risk factors for progression of brain atrophy in aging: six-year follow-up of normal subjects. Neurology, 64, 17041711.
Feng, L. et al. (2013). Metabolic syndrome and amnestic mild cognitive impairment: Singapore Longitudinal Ageing Study-2 findings. Journal of Alzheimer's Disease, 34, 649657.
Fowler, K. S., Saling, M. M., Conway, E. L., Semple, J. M. and Louis, W. J. (2002). Paired associate performance in the early detection of DAT. Journal of the International Neuropsychological Society, 8, 5871.
Furie, K. L. and Smith, E. E. (2007). Metabolic syndrome: a target for preventing leukoaraiosis and age-related dementia? Neurology, 69, 951952.
Gama, R., Elfatih, A. B. and Anderson, N. R. (2002). Ethnic differences in total and HDL cholesterol concentrations: Caucasians compared with predominantly Punjabi Sikh Indo-Asians. Annals of Clinical Biochemistry, 39, 609611.
Giannopoulos, S. et al. (2010). Metabolic syndrome and cerebral vasomotor reactivity. European Journal of Neurology, 17, 14571462.
Goldstein, F. C., Ashley, A. V., Endeshaw, Y. W., Hanfelt, J., Lah, J. J. and Levey, A. I. (2008). Effects of hypertension and hypercholesterolemia on cognitive functioning in patients with Alzheimer disease. Alzheimer Disease and Associated Disorders, 22, 336342.
Hammers, D. et al. (2011). Using the CANTAB computerized battery to discriminate mild cognitive impairment and dementias. Alzheimer's and Dementia: The Journal of the Alzheimer's Association, 7, S537.
Hassenstab, J. J., Sweat, V., Bruehl, H. and Convit, A. (2010). Metabolic Syndrome is associated with learning and recall impairment in middle age. Dementia and Geriatric Cognitive Disorders, 29, 356362.
Hilal, S. et al. (2013). Prevalence of cognitive impairment in Chinese: epidemiology of dementia in Singapore study. Journal of Neurology, Neurosurgery and Psychiatry, 84, 686692.
Ho, R. C., Niti, M., Yap, K. B., Kua, E. H. and Ng, T. P. (2008). Metabolic syndrome and cognitive decline in Chinese older adults: results from the Singapore longitudinal ageing studies. American Journal of Geriatric Psychiatry, 16, 519522.
Janus, E. D. (2004). Metabolic Syndrome and its relevance to Asia. International Congress Series, 1262, 535537.
Junkkila, J., Oja, S., Laine, M. and Karrasch, M. (2012). Applicability of the CANTAB-PAL computerized memory test in identifying amnestic mild cognitive impairment and Alzheimer's disease. Dementia and Geriatrics Cognitive Disorders, 32, 8389.
Koivistoinen, T. et al. (2011). Metabolic Syndrome in childhood and increased arterial stiffness in adulthood: the Cardiovascular Risk in Young Finns Study. Annals of Internal Medicine, 43, 312319.
Kwon, H. M., Kim, B. J., Lee, S. H., Choi, S. H., Oh, B. H. and Yoon, B. W. (2006). Metabolic Syndrome as an independent risk factor of silent brain infarction in healthy people. Stroke, 37, 466472.
Laudisio, A. et al. (2008). Association of metabolic syndrome with cognitive function: the role of sex and age. Clinical Nutrition, 27, 747754.
Lee, A. Y., Kim, J. S., Choi, B. H. and Sohn, E. H. (2009). Characteristics of Clock Drawing Test (CDT) errors by the dementia type: quantitative and qualitative analyses. Archives of Gerontology and Geriatrics, 48, 5860.
Lee, C. K. Y., Collinson, S. L., Feng, L. and Ng, T. (2012). Preliminary normative neuropsychological data for an elderly Chinese population. The Clinical Neuropsychologist, 26, 321334.
Lee, A., Archer, J., Wong, C. K. Y, Chen, S. H. A. and Qiu, A. (2013) Age-related decline in associative learning in healthy Chinese adults. PLoS ONE, 8, e80648.
Misra, A. and Khurana, L. (2009). The Metabolic Syndrome in South Asians: epidemiology, determinants, and prevention. Metabolic Syndromes and Related Disorders, 7, 497514.
Misra, A., Misra, R., Wijesuriya, M. and Banerjee, D. (2007). The Metabolic Syndrome in South Asians: continuing escalation and possible escalation and possible solutions. Indian Journal of Medical Research, 125, 345354.
Mitchell, J., Arnold, R., Dawson, K., Nestor, P. J. and Hodges, J. R. (2009). Outcome in subgroups of mild cognitive impairment (MCI) is highly predictable using a simple algorithm. Journal of Neurology, 256, 15001509.
Muller, M., Tang, M. X., Schupf, N., Manly, J. J., Mayeux, R. and Luchsinger, J. A. (2007). Metabolic Syndrome and dementia risk in a multiethnic elderly cohort. Dementia and Geriatric Cognitive Disorders, 24, 185192.
Muller, M. et al. (2010). Metabolic Syndrome and cognition in patients with manifest atherosclerotic disease: the SMART Study. Neuroepidemiology, 34, 8389.
Muller, M., van der Graaf, Y., Algra, A., Hendrikse, J., Mali, W. P. and Geerlings, M. I. (2011). SMART Study Group. Carotid atherosclerosis and progression of brain atrophy: the SMART-MR study. Annals of Neurology, 70, 237244.
Nestor, P. J., Scheltens, P. and Hodges, J. R. (2004). Advances in the early detection of Alzheimer's disease. Nature Medicine, 10 (Suppl), S3441.
Ng, T. P. (2009). Primary Prevention of Dementia: Research Findings From the Singapore Longitudinal Ageing Studies. 24th International Conference of Alzheimer's Disease International (ADI 2009), March 25–28, 2009, Singapore. ‘Dementia: Engaging Societies Around The World’. Parallel Session: ‘Dementia Care and Research in Asian Countries’.
Nordlund, A., Rolstad, S., Klang, O., Lind, K., Hansen, S. and Wallin, A. (2007). Cognitive profiles of mild cognitive impairment with and without vascular disease. Neuropsychology, 21, 706712.
Oveisgharan, S. and Hachinski, V. (2010). Hypertension, executive dysfunction, and progression to dementia: the Canadian Study of Health and Aging. Archives of Neurology, 67, 187192.
Panza, F. et al. (2010). Metabolic Syndrome and cognitive impairment: current epidemiology and possible underlying mechanisms. Journal of Alzheimer's Disease, 21, 691724.
Panza, F. et al. (2011). Metabolic syndrome, mild cognitive impairment and dementia. Current Alzheimer Research, 8, 492509.
Raz, N., Rodrigue, K. M. and Acker, J. D. (2003). Hypertension and the brain: vulnerability of the prefrontal regions and executive functions. Behavioral Neuroscience, 117, 11691180.
Raz, N., Rodrigue, K. M., Acker, J. D. and Kennedy, K. M. (2007). Vascular health and longitudinal changes in brain and cognition in middle-aged and older adults. Neuropsychology, 21, 149157.
Roberts, R. O. et al. (2010). Metabolic Syndrome, inflammation, and non-amnestic mild cognitive impairment in older persons: a population-based study. Alzheimer Disease and Associated Disorders, 24, 1118.
Romero, J. R. et al. (2009). Carotid artery atherosclerosis, MRI indices of brain ischemia, aging, and cognitive impairment: the Framingham study. Stroke, 40, 15901596.
Sahadevan, S. et al. (2008). Ethnic differences in Singapore's dementia prevalence: the stroke, Parkinson's disease, epilepsy, and dementia in Singapore Study. The American Geriatrics Society, 56, 20612068.
Schmidt, R. et al. (2005). White matter lesion progression, brain atrophy, and cognitive decline: the Austrian Stroke Prevention Study. Annals of Neurology, 58, 610616.
Schuur, M. et al. (2010). Insulin-resistance and metabolic syndrome are related to executive function in women in a large family-based study. European Journal of Epidemiology, 25, 561568.
Segura, B., Jurado, M. A., Freixenet, N., Albuin, C., Muniesa, J. and Junque, C. (2009). Mental slowness and executive dysfunctions in patients with metabolic syndrome. Neuroscience Letters, 462, 4953.
Solfrizzi, V., Scafato, E., Capurso, C., D’Introno, A., Colacicco, A. M. and Frisardi, V. (2010). Metabolic syndrome and the risk of vascular dementia: the Italian Longitudinal Study on aging. Journal of Neurology, Neurosurgery, and Psychiatry, 81, 433440.
Swainson, R. et al. (2001) Early detection and differential diagnosis of Alzheimer's disease and depression with neuropsychological tasks. Dementia and Geriatric Cognitive Disorders, 12, 265280.
Tan, C.-E., Ma, S., Wai, D., Chew, S.-K. and Tai, E.-S. (2004). Can you apply the national cholesterol education program adult treatment panel definition of the metabolic syndrome to Asians. Diabetes Care, 27, 11821186.
van den Berg, E., Biessels, G. J., de Craen, A. J., Gussekloo, J. and Westendorp, R. G. (2007). The metabolic syndrome is associated with decelerated cognitive decline in the oldest old. Neurology, 69, 979985.
Vanhanen, M. et al. (2006). Association of metabolic syndrome with Alzheimer disease: a population-based study. Neurology, 67, 843847.
Waldstein, S. R. et al. (1996). Hypertension and neuropsychological performance in men: interactive effects of age. Health Psychology, 15, 102109.
Wang, J., Ruotsalainen, S., Moilanen, L., Lepistö, P., Laakso, M. and Kuusisto, J. (2008). The metabolic syndrome predicts incident stroke: a 14-year follow-up study in elderly people in Finland. Stroke, 39, 10781083.
Winer, B. J. (1970). Statistical Principles in Experimental Design, 2nd edn. New York, NY: McGraw-Hill.
World Health Organization Expert Consultation. (2004). Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. The Lancet, 363, 157163.
Yaffe, K., Weston, A. L., Blackwell, T. and Kruegar, K. A. (2009). The Metabolic Syndrome and development of cognitive impairment among older women. JAMA Neurology, 66, 324328.
Yates, K. F., Sweat, V., Yau, P. L., Turchiano, M. M. and Convit, A. (2012). Impact of Metabolic Syndrome on cognition and brain: a selected review of the literature. Arteriosclerosis, Thrombosis, and Vascular Biology, 32, 20602067.
Yoshita, M. et al. (2006). Extent and distribution of white matter hyperintensities in normal aging, MCI, and AD. Neurology, 26, 21922198.
Zhang, J., McKeown, R. and Hajjar, I. (2005). Serum cholesterol levels are associated with impaired recall memory among older people. Age and Ageing, 34, 178182.

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Midlife metabolic syndrome and neurocognitive function in a mixed Asian sample

  • Simon L. Collinson (a1), Sandy J. F. Tong (a2), Sarah S. K. Loh (a1), S. B. Chionh (a2) and Reshma A. Merchant (a2)...

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