The metabolic syndrome, inflammation, and risk of cognitive decline

Kristine Yaffe, Alka Kanaya, Karla Lindquist, Eleanor M. Simonsick, Tamara Harris, Ronald I. Shorr, Frances Tylavsky, Anne B. Newman

Research output: Contribution to journalArticle

646 Citations (Scopus)

Abstract

Context: Several studies have reported an association between the metabolic syndrome and cardiovascular disease. Despite an increasing awareness that cardiovascular risk factors increase risk of cognitive decline and dementia, there are few data on the metabolic syndrome and cognition. Objective: To determine if the metabolic syndrome is a risk factor for cognitive decline and if this association is modified by inflammation. Design and Setting: A 5-year prospective observational study conducted from 1997 to 2002 at community clinics at 2 sites. Participants: A total of 2632 black and white elders (mean age, 74 years). Main Outcome Measures: Association of the metabolic syndrome (measured using National Cholesterol Education Program guidelines) and high inflammation (defined as above median serum level of interleukin 6 and C-reactive protein) with change in cognition (Modified Mini-Mental State Examination [3MS]) at 3 and 5 years. Cognitive impairment was defined as at least a 5-point decline. Results: Compared with those without the metabolic syndrome (n=1616), elders with the metabolic syndrome (n=1016) were more likely to have cognitive impairment (26% vs 21%, multivariate adjusted relative risk [RR], 1.20; 95% confidence interval [CI], 1.02-1.41). There was a statistically significant interaction with inflammation and the metabolic syndrome (P=.03) on cognitive impairment. After stratifying for inflammation, those with the metabolic syndrome and high inflammation (n=348) had an increased likelihood of cognitive impairment compared with those without the metabolic syndrome (multivariate adjusted RR, 1.66; 95% CI, 1.19-2.32). Those with the metabolic syndrome and low inflammation (n=668) did not exhibit an increased likelihood of impairment (multivariate adjusted RR, 1.08; 95% CI, 0.89-1.30). Stratified multivariate random-effects models demonstrated that participants with the metabolic syndrome and high inflammation had greater 4-year decline on 3MS (P=.04) compared with those without the metabolic syndrome, whereas those with the metabolic syndrome and low inflammation did not (P=.44). Conclusion: These findings support the hypothesis that the metabolic syndrome contributes to cognitive impairment in elders, but primarily in those with high level of inflammation.

Original languageEnglish (US)
Pages (from-to)2237-2242
Number of pages6
JournalJournal of the American Medical Association
Volume292
Issue number18
DOIs
StatePublished - Nov 10 2004

Fingerprint

Inflammation
Confidence Intervals
Cognitive Dysfunction
Cognition
Sambucus nigra
Metabolic Diseases
C-Reactive Protein
Observational Studies
Dementia
Interleukin-6
Cardiovascular Diseases
Cholesterol
Outcome Assessment (Health Care)
Prospective Studies
Guidelines
Education
Serum

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Yaffe, K., Kanaya, A., Lindquist, K., Simonsick, E. M., Harris, T., Shorr, R. I., ... Newman, A. B. (2004). The metabolic syndrome, inflammation, and risk of cognitive decline. Journal of the American Medical Association, 292(18), 2237-2242. https://doi.org/10.1001/jama.292.18.2237

The metabolic syndrome, inflammation, and risk of cognitive decline. / Yaffe, Kristine; Kanaya, Alka; Lindquist, Karla; Simonsick, Eleanor M.; Harris, Tamara; Shorr, Ronald I.; Tylavsky, Frances; Newman, Anne B.

In: Journal of the American Medical Association, Vol. 292, No. 18, 10.11.2004, p. 2237-2242.

Research output: Contribution to journalArticle

Yaffe, K, Kanaya, A, Lindquist, K, Simonsick, EM, Harris, T, Shorr, RI, Tylavsky, F & Newman, AB 2004, 'The metabolic syndrome, inflammation, and risk of cognitive decline', Journal of the American Medical Association, vol. 292, no. 18, pp. 2237-2242. https://doi.org/10.1001/jama.292.18.2237
Yaffe K, Kanaya A, Lindquist K, Simonsick EM, Harris T, Shorr RI et al. The metabolic syndrome, inflammation, and risk of cognitive decline. Journal of the American Medical Association. 2004 Nov 10;292(18):2237-2242. https://doi.org/10.1001/jama.292.18.2237
Yaffe, Kristine ; Kanaya, Alka ; Lindquist, Karla ; Simonsick, Eleanor M. ; Harris, Tamara ; Shorr, Ronald I. ; Tylavsky, Frances ; Newman, Anne B. / The metabolic syndrome, inflammation, and risk of cognitive decline. In: Journal of the American Medical Association. 2004 ; Vol. 292, No. 18. pp. 2237-2242.
@article{473c013748c243fd97373977d65f7a48,
title = "The metabolic syndrome, inflammation, and risk of cognitive decline",
abstract = "Context: Several studies have reported an association between the metabolic syndrome and cardiovascular disease. Despite an increasing awareness that cardiovascular risk factors increase risk of cognitive decline and dementia, there are few data on the metabolic syndrome and cognition. Objective: To determine if the metabolic syndrome is a risk factor for cognitive decline and if this association is modified by inflammation. Design and Setting: A 5-year prospective observational study conducted from 1997 to 2002 at community clinics at 2 sites. Participants: A total of 2632 black and white elders (mean age, 74 years). Main Outcome Measures: Association of the metabolic syndrome (measured using National Cholesterol Education Program guidelines) and high inflammation (defined as above median serum level of interleukin 6 and C-reactive protein) with change in cognition (Modified Mini-Mental State Examination [3MS]) at 3 and 5 years. Cognitive impairment was defined as at least a 5-point decline. Results: Compared with those without the metabolic syndrome (n=1616), elders with the metabolic syndrome (n=1016) were more likely to have cognitive impairment (26{\%} vs 21{\%}, multivariate adjusted relative risk [RR], 1.20; 95{\%} confidence interval [CI], 1.02-1.41). There was a statistically significant interaction with inflammation and the metabolic syndrome (P=.03) on cognitive impairment. After stratifying for inflammation, those with the metabolic syndrome and high inflammation (n=348) had an increased likelihood of cognitive impairment compared with those without the metabolic syndrome (multivariate adjusted RR, 1.66; 95{\%} CI, 1.19-2.32). Those with the metabolic syndrome and low inflammation (n=668) did not exhibit an increased likelihood of impairment (multivariate adjusted RR, 1.08; 95{\%} CI, 0.89-1.30). Stratified multivariate random-effects models demonstrated that participants with the metabolic syndrome and high inflammation had greater 4-year decline on 3MS (P=.04) compared with those without the metabolic syndrome, whereas those with the metabolic syndrome and low inflammation did not (P=.44). Conclusion: These findings support the hypothesis that the metabolic syndrome contributes to cognitive impairment in elders, but primarily in those with high level of inflammation.",
author = "Kristine Yaffe and Alka Kanaya and Karla Lindquist and Simonsick, {Eleanor M.} and Tamara Harris and Shorr, {Ronald I.} and Frances Tylavsky and Newman, {Anne B.}",
year = "2004",
month = "11",
day = "10",
doi = "10.1001/jama.292.18.2237",
language = "English (US)",
volume = "292",
pages = "2237--2242",
journal = "JAMA - Journal of the American Medical Association",
issn = "0002-9955",
publisher = "American Medical Association",
number = "18",

}

TY - JOUR

T1 - The metabolic syndrome, inflammation, and risk of cognitive decline

AU - Yaffe, Kristine

AU - Kanaya, Alka

AU - Lindquist, Karla

AU - Simonsick, Eleanor M.

AU - Harris, Tamara

AU - Shorr, Ronald I.

AU - Tylavsky, Frances

AU - Newman, Anne B.

PY - 2004/11/10

Y1 - 2004/11/10

N2 - Context: Several studies have reported an association between the metabolic syndrome and cardiovascular disease. Despite an increasing awareness that cardiovascular risk factors increase risk of cognitive decline and dementia, there are few data on the metabolic syndrome and cognition. Objective: To determine if the metabolic syndrome is a risk factor for cognitive decline and if this association is modified by inflammation. Design and Setting: A 5-year prospective observational study conducted from 1997 to 2002 at community clinics at 2 sites. Participants: A total of 2632 black and white elders (mean age, 74 years). Main Outcome Measures: Association of the metabolic syndrome (measured using National Cholesterol Education Program guidelines) and high inflammation (defined as above median serum level of interleukin 6 and C-reactive protein) with change in cognition (Modified Mini-Mental State Examination [3MS]) at 3 and 5 years. Cognitive impairment was defined as at least a 5-point decline. Results: Compared with those without the metabolic syndrome (n=1616), elders with the metabolic syndrome (n=1016) were more likely to have cognitive impairment (26% vs 21%, multivariate adjusted relative risk [RR], 1.20; 95% confidence interval [CI], 1.02-1.41). There was a statistically significant interaction with inflammation and the metabolic syndrome (P=.03) on cognitive impairment. After stratifying for inflammation, those with the metabolic syndrome and high inflammation (n=348) had an increased likelihood of cognitive impairment compared with those without the metabolic syndrome (multivariate adjusted RR, 1.66; 95% CI, 1.19-2.32). Those with the metabolic syndrome and low inflammation (n=668) did not exhibit an increased likelihood of impairment (multivariate adjusted RR, 1.08; 95% CI, 0.89-1.30). Stratified multivariate random-effects models demonstrated that participants with the metabolic syndrome and high inflammation had greater 4-year decline on 3MS (P=.04) compared with those without the metabolic syndrome, whereas those with the metabolic syndrome and low inflammation did not (P=.44). Conclusion: These findings support the hypothesis that the metabolic syndrome contributes to cognitive impairment in elders, but primarily in those with high level of inflammation.

AB - Context: Several studies have reported an association between the metabolic syndrome and cardiovascular disease. Despite an increasing awareness that cardiovascular risk factors increase risk of cognitive decline and dementia, there are few data on the metabolic syndrome and cognition. Objective: To determine if the metabolic syndrome is a risk factor for cognitive decline and if this association is modified by inflammation. Design and Setting: A 5-year prospective observational study conducted from 1997 to 2002 at community clinics at 2 sites. Participants: A total of 2632 black and white elders (mean age, 74 years). Main Outcome Measures: Association of the metabolic syndrome (measured using National Cholesterol Education Program guidelines) and high inflammation (defined as above median serum level of interleukin 6 and C-reactive protein) with change in cognition (Modified Mini-Mental State Examination [3MS]) at 3 and 5 years. Cognitive impairment was defined as at least a 5-point decline. Results: Compared with those without the metabolic syndrome (n=1616), elders with the metabolic syndrome (n=1016) were more likely to have cognitive impairment (26% vs 21%, multivariate adjusted relative risk [RR], 1.20; 95% confidence interval [CI], 1.02-1.41). There was a statistically significant interaction with inflammation and the metabolic syndrome (P=.03) on cognitive impairment. After stratifying for inflammation, those with the metabolic syndrome and high inflammation (n=348) had an increased likelihood of cognitive impairment compared with those without the metabolic syndrome (multivariate adjusted RR, 1.66; 95% CI, 1.19-2.32). Those with the metabolic syndrome and low inflammation (n=668) did not exhibit an increased likelihood of impairment (multivariate adjusted RR, 1.08; 95% CI, 0.89-1.30). Stratified multivariate random-effects models demonstrated that participants with the metabolic syndrome and high inflammation had greater 4-year decline on 3MS (P=.04) compared with those without the metabolic syndrome, whereas those with the metabolic syndrome and low inflammation did not (P=.44). Conclusion: These findings support the hypothesis that the metabolic syndrome contributes to cognitive impairment in elders, but primarily in those with high level of inflammation.

UR - http://www.scopus.com/inward/record.url?scp=7744239901&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=7744239901&partnerID=8YFLogxK

U2 - 10.1001/jama.292.18.2237

DO - 10.1001/jama.292.18.2237

M3 - Article

VL - 292

SP - 2237

EP - 2242

JO - JAMA - Journal of the American Medical Association

JF - JAMA - Journal of the American Medical Association

SN - 0002-9955

IS - 18

ER -