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Modeling Metabolic Syndrome and Its Association with Cognition: The Northern Manhattan Study

Published online by Cambridge University Press:  10 November 2014

Bonnie E. Levin*
Evelyn F. McKnight Brain Institute, Department of Neurology, University of Miami Leonard M. Miller School of Medicine, Miami, Florida Deparment of Psychology, University of Miami, Miami, Florida
Maria M. Llabre
Deparment of Psychology, University of Miami, Miami, Florida
Chuanhui Dong
Evelyn F. McKnight Brain Institute, Department of Neurology, University of Miami Leonard M. Miller School of Medicine, Miami, Florida
Mitchell S.V. Elkind
Department of Neurology, Columbia University, New York, New York
Yaakov Stern
Cognitve Neuroscience Division, Department of Neurology, Columbia University, New York, New York
Tatjana Rundek
Evelyn F. McKnight Brain Institute, Department of Neurology, University of Miami Leonard M. Miller School of Medicine, Miami, Florida Department of Public Health Sciences, University of Miami Leonard M. Miller School of Medicine, Miami, Florida
Ralph L. Sacco
Evelyn F. McKnight Brain Institute, Department of Neurology, University of Miami Leonard M. Miller School of Medicine, Miami, Florida Department of Public Health Sciences, University of Miami Leonard M. Miller School of Medicine, Miami, Florida Hussman Institute for Human Genomics, University of Miami Leonard M. Miller School of Medicine, Miami, Florida
Clinton B. Wright
Evelyn F. McKnight Brain Institute, Department of Neurology, University of Miami Leonard M. Miller School of Medicine, Miami, Florida Hussman Institute for Human Genomics, University of Miami Leonard M. Miller School of Medicine, Miami, Florida
Correspondence and reprint requests to: Bonnie E. Levin, Division of Neuropsychology, 1120 NW 14th Street, Ste 1337, Miami, Fl 33136. E-mail:


Metabolic syndrome (MetS) is a clustering of vascular risk factors and is associated with increased risk of cardiovascular disease. Less is known about the relationship between MetS and cognition. We examined component vascular risk factors of MetS as correlates of different cognitive domains. The Northern Manhattan Study (NOMAS) includes 1290 stroke-free participants from a largely Hispanic multi-ethnic urban community. We used structural equation modeling (SEM) to model latent variables of MetS, assessed at baseline and an average of 10 years later, at which time participants also underwent a full cognitive battery. The two four-factor models, of the metabolic syndrome (blood pressure, lipid levels, obesity, and fasting glucose) and of cognition (language, executive function, psychomotor, and memory), were each well supported (CFI=0.97 and CFI=0.95, respectively). When the two models were combined, the correlation between metabolic syndrome and cognition was −.31. Among the metabolic syndrome components, only blood pressure uniquely predicted all four cognitive domains. After adjusting for age, gender, race/ethnicity, education, smoking, alcohol, and risk factor treatment variables, blood pressure remained a significant correlate of all domains except memory. In this stroke-free race/ethnically diverse community-based cohort, MetS was associated with cognitive function suggesting that MetS and its components may be important predictors of cognitive outcomes. After adjusting for sociodemographic and vascular risk factors, blood pressure was the strongest correlate of cognitive performance. Findings suggest MetS, and in particular blood pressure, may represent markers of vascular or neurodegenerative damage in aging populations. (JINS, 2014, 20, 1–10)

Research Articles
Copyright © The International Neuropsychological Society 2014 

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