Metabolic syndrome and its effect in dementia: Not your typical memory loss symptoms

Background Alzheimer Disease (AD) is the most prevalent form of dementia and the fourth cause of death in Puerto Rico (1). While perhaps there are no treatments for AD, treating modifiable risk factors offers opportunities for prevention of dementia concomitantly. Objective: Primary end point was to find an association between the Metabolic Syndrome (MetS), its individual component, and dementia in a puertorrican population ≥ 65 years old. The secondary end point was to determine which aspects of cognition (Memory, Orientation, Judgment, Community affairs, Home/hobbies and Personal care) are mostly affected. Method Cross sectional study with 135 puertorricans ≥ 65 y/o with family history of Early Onset Alzheimer’s Disease (EOAD) who were divided by having MetS (n=47) vs without (n=88). MetS was defined by the National Cholesterol Education Program criteria. Waist circumference measurement was adapted with body mass index ≥ 30 kg/m2. Cognition function was assessed by the Clinical Dementia Rating (CDR) Scale. Result Our study revealed no significant statistical association between MetS and moderate dementia in the participants ≥65 years old with family history of EOAD using the CDR Scale. Nonetheless, BMI ≥ 30 kg/m2 in participants with MetS was found to have a significant statistical association, or a trend towards significance, with moderate dementia in 5 out of 6 domains of cognitive performance, as per CDR ≥2: Memory (p= 0.066), Orientation (p=0.21), Community‐interactions (p= 0.040), Judgment (p=0.040) and Hobbies/Home (p= 0.099). Conclusion MetS had no statistical association with dementia. However, BMI ≥30 kg/m2 was associated with dementia, mostly affecting orientation, judgment and community tasks, not necessarily the typical memory loss. BMI’s ideal goal needs to be achieved and must be considered a priority in the patient’s primary care management. Clinically, ≥65 y/o puertorrican patients with MetS should be screened for dementia assessing the capacities to perform activities of daily living (ADL’s) not only memory tests, as part of preventive medicine.