Metabolic Syndrome and Cognitive Impairment among High Socioeconomic, Nondemented Older US Adults
OBJECTIVES Nondemented cognitive impairment (CI) presents opportunities for early interventions among individuals at risk for dementia. Identification of modifiable determinants is paramount to the development of effective clinical interventions. Metabolic syndrome (MetS) was theorized as a risk fac...
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| Veröffentlicht in: | Journal of the American Geriatrics Society (JAGS) 2019-07, Vol.67 (7), p.1437-1443 |
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| container_title | Journal of the American Geriatrics Society (JAGS) |
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| creator | Martinez‐Miller, Erline E. Kohl, Harold W. Barlow, Carolyn E. Willis, Benjamin L. DeFina, Laura F. |
| description | OBJECTIVES
Nondemented cognitive impairment (CI) presents opportunities for early interventions among individuals at risk for dementia. Identification of modifiable determinants is paramount to the development of effective clinical interventions. Metabolic syndrome (MetS) was theorized as a risk factor, but current research yields inconsistent findings. Few studies have examined the association between MetS and CI among US populations, and global results may be ungeneralizable. We investigated the MetS‐CI association among high socioeconomic, nondemented older US adults, examining the roles of sociodemographic, clinical, behavioral, and genetic factors.
DESIGN
Cross‐sectional.
SETTING
Cooper Clinic of Dallas, Texas: Cooper Center Longitudinal Study (2009‐2017).
PARTICIPANTS
A total of 5200 dementia‐free older adult Cooper Clinic patients.
MEASUREMENTS
CI was detected with a Montreal Cognitive Assessment (MoCA) score lower than 26. MetS was established based on National Cholesterol Education Program Adult Treatment Panel guidelines. Unadjusted and multivariable log‐binomial regression were used to assess the MetS‐CI association, with modification assessment by age, sex, education, cardiorespiratory fitness (CRF), and apolipoprotein‐ε4 carrier status (APOE‐ε4).
RESULTS
MetS was not associated with CI when adjusting for age, sex, minority status, education, and marital status (prevalence ratio [PR] = 1.09; 95% confidence interval = .97‐1.23) or when additionally adjusting for body mass index, CRF, alcohol consumption, current smoking status, and APOE‐ε4 (PR = 1.07; 95% confidence interval = .80‐1.45). The association was not modified by age, sex, CRF, or APOE‐ε4 (P for interaction >.05).
CONCLUSION
In contrast with some global and US studies, MetS and CI were not associated among our study population of nondemented older US adults. MetS may not be a suitable intervention target for poor cognitive outcomes among high socioeconomic older US adults, although separate MetS components may have different recommendations. Future studies should explore more diverse older US populations. If replicated, these findings would inform clinical efforts to reduce the burden of poor cognitive outcomes in the United States. |
| doi_str_mv | 10.1111/jgs.15836 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2190108243</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2190108243</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3536-99636c01db8401b2c60162d9fea6515e87d455067188ef2186fc199c8e17ca923</originalsourceid><addsrcrecordid>eNp10EFLHDEUB_AgFt2qB7-ABLxY6GheZpLNHGVp1WL1sHoO2eTNmmUmWZMZZb99x671IPTx4F1-_Hn8CTkGdg7jXKyW-RyEKuUOmYAoeSEqELtkwhjjhZJQ7ZOvOa8YA86U2iP7JVOiklU1IeY39mYRW2_pfBNcih1SExydxWXwvX9BetOtjU8dhp6aLoYlvfbLJzqP1ke0McTO2-_0LgaHbwYdvW8dJvo4p5duaPt8SL40ps149H4PyOPPHw-z6-L2_upmdnlb2FKUsqhrWUrLwC1UxWDBrWQguasbNFKAQDV1lRBMTkEpbDgo2Vioa6sQptbUvDwgZ9vcdYrPA-Zedz5bbFsTMA5Zc6gZMMWrcqSnn-gqDimM32nOxbgAtRjVt62yKeacsNHr5DuTNhqYfutdj73rv72P9uQ9cVh06D7kv6JHcLEFr77Fzf-T9K-r-TbyD6omioM</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2252251195</pqid></control><display><type>article</type><title>Metabolic Syndrome and Cognitive Impairment among High Socioeconomic, Nondemented Older US Adults</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Martinez‐Miller, Erline E. ; Kohl, Harold W. ; Barlow, Carolyn E. ; Willis, Benjamin L. ; DeFina, Laura F.</creator><creatorcontrib>Martinez‐Miller, Erline E. ; Kohl, Harold W. ; Barlow, Carolyn E. ; Willis, Benjamin L. ; DeFina, Laura F.</creatorcontrib><description>OBJECTIVES
Nondemented cognitive impairment (CI) presents opportunities for early interventions among individuals at risk for dementia. Identification of modifiable determinants is paramount to the development of effective clinical interventions. Metabolic syndrome (MetS) was theorized as a risk factor, but current research yields inconsistent findings. Few studies have examined the association between MetS and CI among US populations, and global results may be ungeneralizable. We investigated the MetS‐CI association among high socioeconomic, nondemented older US adults, examining the roles of sociodemographic, clinical, behavioral, and genetic factors.
DESIGN
Cross‐sectional.
SETTING
Cooper Clinic of Dallas, Texas: Cooper Center Longitudinal Study (2009‐2017).
PARTICIPANTS
A total of 5200 dementia‐free older adult Cooper Clinic patients.
MEASUREMENTS
CI was detected with a Montreal Cognitive Assessment (MoCA) score lower than 26. MetS was established based on National Cholesterol Education Program Adult Treatment Panel guidelines. Unadjusted and multivariable log‐binomial regression were used to assess the MetS‐CI association, with modification assessment by age, sex, education, cardiorespiratory fitness (CRF), and apolipoprotein‐ε4 carrier status (APOE‐ε4).
RESULTS
MetS was not associated with CI when adjusting for age, sex, minority status, education, and marital status (prevalence ratio [PR] = 1.09; 95% confidence interval = .97‐1.23) or when additionally adjusting for body mass index, CRF, alcohol consumption, current smoking status, and APOE‐ε4 (PR = 1.07; 95% confidence interval = .80‐1.45). The association was not modified by age, sex, CRF, or APOE‐ε4 (P for interaction >.05).
CONCLUSION
In contrast with some global and US studies, MetS and CI were not associated among our study population of nondemented older US adults. MetS may not be a suitable intervention target for poor cognitive outcomes among high socioeconomic older US adults, although separate MetS components may have different recommendations. Future studies should explore more diverse older US populations. If replicated, these findings would inform clinical efforts to reduce the burden of poor cognitive outcomes in the United States.</description><identifier>ISSN: 0002-8614</identifier><identifier>EISSN: 1532-5415</identifier><identifier>DOI: 10.1111/jgs.15836</identifier><identifier>PMID: 30854644</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>Adults ; Age ; Aged ; Apolipoprotein E ; apolipoprotein‐ε4 ; Body mass index ; Cardiorespiratory fitness ; Cholesterol ; Cognitive ability ; Cognitive Dysfunction - epidemiology ; cognitive impairment ; Confidence intervals ; Cross-Sectional Studies ; Dementia ; Dementia disorders ; Female ; Genetic factors ; Humans ; Male ; Mental Status and Dementia Tests ; Metabolic syndrome ; Metabolic Syndrome - epidemiology ; Middle Aged ; Population studies ; Prospective Studies ; Risk factors ; Sex ; Smoking ; Social Class ; Texas - epidemiology ; United States - epidemiology</subject><ispartof>Journal of the American Geriatrics Society (JAGS), 2019-07, Vol.67 (7), p.1437-1443</ispartof><rights>2019 The American Geriatrics Society</rights><rights>2019 The American Geriatrics Society.</rights><rights>2019 American Geriatrics Society and Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3536-99636c01db8401b2c60162d9fea6515e87d455067188ef2186fc199c8e17ca923</citedby><cites>FETCH-LOGICAL-c3536-99636c01db8401b2c60162d9fea6515e87d455067188ef2186fc199c8e17ca923</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjgs.15836$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjgs.15836$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,777,781,1412,27905,27906,45555,45556</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30854644$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Martinez‐Miller, Erline E.</creatorcontrib><creatorcontrib>Kohl, Harold W.</creatorcontrib><creatorcontrib>Barlow, Carolyn E.</creatorcontrib><creatorcontrib>Willis, Benjamin L.</creatorcontrib><creatorcontrib>DeFina, Laura F.</creatorcontrib><title>Metabolic Syndrome and Cognitive Impairment among High Socioeconomic, Nondemented Older US Adults</title><title>Journal of the American Geriatrics Society (JAGS)</title><addtitle>J Am Geriatr Soc</addtitle><description>OBJECTIVES
Nondemented cognitive impairment (CI) presents opportunities for early interventions among individuals at risk for dementia. Identification of modifiable determinants is paramount to the development of effective clinical interventions. Metabolic syndrome (MetS) was theorized as a risk factor, but current research yields inconsistent findings. Few studies have examined the association between MetS and CI among US populations, and global results may be ungeneralizable. We investigated the MetS‐CI association among high socioeconomic, nondemented older US adults, examining the roles of sociodemographic, clinical, behavioral, and genetic factors.
DESIGN
Cross‐sectional.
SETTING
Cooper Clinic of Dallas, Texas: Cooper Center Longitudinal Study (2009‐2017).
PARTICIPANTS
A total of 5200 dementia‐free older adult Cooper Clinic patients.
MEASUREMENTS
CI was detected with a Montreal Cognitive Assessment (MoCA) score lower than 26. MetS was established based on National Cholesterol Education Program Adult Treatment Panel guidelines. Unadjusted and multivariable log‐binomial regression were used to assess the MetS‐CI association, with modification assessment by age, sex, education, cardiorespiratory fitness (CRF), and apolipoprotein‐ε4 carrier status (APOE‐ε4).
RESULTS
MetS was not associated with CI when adjusting for age, sex, minority status, education, and marital status (prevalence ratio [PR] = 1.09; 95% confidence interval = .97‐1.23) or when additionally adjusting for body mass index, CRF, alcohol consumption, current smoking status, and APOE‐ε4 (PR = 1.07; 95% confidence interval = .80‐1.45). The association was not modified by age, sex, CRF, or APOE‐ε4 (P for interaction >.05).
CONCLUSION
In contrast with some global and US studies, MetS and CI were not associated among our study population of nondemented older US adults. MetS may not be a suitable intervention target for poor cognitive outcomes among high socioeconomic older US adults, although separate MetS components may have different recommendations. Future studies should explore more diverse older US populations. If replicated, these findings would inform clinical efforts to reduce the burden of poor cognitive outcomes in the United States.</description><subject>Adults</subject><subject>Age</subject><subject>Aged</subject><subject>Apolipoprotein E</subject><subject>apolipoprotein‐ε4</subject><subject>Body mass index</subject><subject>Cardiorespiratory fitness</subject><subject>Cholesterol</subject><subject>Cognitive ability</subject><subject>Cognitive Dysfunction - epidemiology</subject><subject>cognitive impairment</subject><subject>Confidence intervals</subject><subject>Cross-Sectional Studies</subject><subject>Dementia</subject><subject>Dementia disorders</subject><subject>Female</subject><subject>Genetic factors</subject><subject>Humans</subject><subject>Male</subject><subject>Mental Status and Dementia Tests</subject><subject>Metabolic syndrome</subject><subject>Metabolic Syndrome - epidemiology</subject><subject>Middle Aged</subject><subject>Population studies</subject><subject>Prospective Studies</subject><subject>Risk factors</subject><subject>Sex</subject><subject>Smoking</subject><subject>Social Class</subject><subject>Texas - epidemiology</subject><subject>United States - epidemiology</subject><issn>0002-8614</issn><issn>1532-5415</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp10EFLHDEUB_AgFt2qB7-ABLxY6GheZpLNHGVp1WL1sHoO2eTNmmUmWZMZZb99x671IPTx4F1-_Hn8CTkGdg7jXKyW-RyEKuUOmYAoeSEqELtkwhjjhZJQ7ZOvOa8YA86U2iP7JVOiklU1IeY39mYRW2_pfBNcih1SExydxWXwvX9BetOtjU8dhp6aLoYlvfbLJzqP1ke0McTO2-_0LgaHbwYdvW8dJvo4p5duaPt8SL40ps149H4PyOPPHw-z6-L2_upmdnlb2FKUsqhrWUrLwC1UxWDBrWQguasbNFKAQDV1lRBMTkEpbDgo2Vioa6sQptbUvDwgZ9vcdYrPA-Zedz5bbFsTMA5Zc6gZMMWrcqSnn-gqDimM32nOxbgAtRjVt62yKeacsNHr5DuTNhqYfutdj73rv72P9uQ9cVh06D7kv6JHcLEFr77Fzf-T9K-r-TbyD6omioM</recordid><startdate>201907</startdate><enddate>201907</enddate><creator>Martinez‐Miller, Erline E.</creator><creator>Kohl, Harold W.</creator><creator>Barlow, Carolyn E.</creator><creator>Willis, Benjamin L.</creator><creator>DeFina, Laura F.</creator><general>John Wiley & Sons, Inc</general><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7TK</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>201907</creationdate><title>Metabolic Syndrome and Cognitive Impairment among High Socioeconomic, Nondemented Older US Adults</title><author>Martinez‐Miller, Erline E. ; Kohl, Harold W. ; Barlow, Carolyn E. ; Willis, Benjamin L. ; DeFina, Laura F.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3536-99636c01db8401b2c60162d9fea6515e87d455067188ef2186fc199c8e17ca923</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adults</topic><topic>Age</topic><topic>Aged</topic><topic>Apolipoprotein E</topic><topic>apolipoprotein‐ε4</topic><topic>Body mass index</topic><topic>Cardiorespiratory fitness</topic><topic>Cholesterol</topic><topic>Cognitive ability</topic><topic>Cognitive Dysfunction - epidemiology</topic><topic>cognitive impairment</topic><topic>Confidence intervals</topic><topic>Cross-Sectional Studies</topic><topic>Dementia</topic><topic>Dementia disorders</topic><topic>Female</topic><topic>Genetic factors</topic><topic>Humans</topic><topic>Male</topic><topic>Mental Status and Dementia Tests</topic><topic>Metabolic syndrome</topic><topic>Metabolic Syndrome - epidemiology</topic><topic>Middle Aged</topic><topic>Population studies</topic><topic>Prospective Studies</topic><topic>Risk factors</topic><topic>Sex</topic><topic>Smoking</topic><topic>Social Class</topic><topic>Texas - epidemiology</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Martinez‐Miller, Erline E.</creatorcontrib><creatorcontrib>Kohl, Harold W.</creatorcontrib><creatorcontrib>Barlow, Carolyn E.</creatorcontrib><creatorcontrib>Willis, Benjamin L.</creatorcontrib><creatorcontrib>DeFina, Laura F.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American Geriatrics Society (JAGS)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Martinez‐Miller, Erline E.</au><au>Kohl, Harold W.</au><au>Barlow, Carolyn E.</au><au>Willis, Benjamin L.</au><au>DeFina, Laura F.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Metabolic Syndrome and Cognitive Impairment among High Socioeconomic, Nondemented Older US Adults</atitle><jtitle>Journal of the American Geriatrics Society (JAGS)</jtitle><addtitle>J Am Geriatr Soc</addtitle><date>2019-07</date><risdate>2019</risdate><volume>67</volume><issue>7</issue><spage>1437</spage><epage>1443</epage><pages>1437-1443</pages><issn>0002-8614</issn><eissn>1532-5415</eissn><abstract>OBJECTIVES
Nondemented cognitive impairment (CI) presents opportunities for early interventions among individuals at risk for dementia. Identification of modifiable determinants is paramount to the development of effective clinical interventions. Metabolic syndrome (MetS) was theorized as a risk factor, but current research yields inconsistent findings. Few studies have examined the association between MetS and CI among US populations, and global results may be ungeneralizable. We investigated the MetS‐CI association among high socioeconomic, nondemented older US adults, examining the roles of sociodemographic, clinical, behavioral, and genetic factors.
DESIGN
Cross‐sectional.
SETTING
Cooper Clinic of Dallas, Texas: Cooper Center Longitudinal Study (2009‐2017).
PARTICIPANTS
A total of 5200 dementia‐free older adult Cooper Clinic patients.
MEASUREMENTS
CI was detected with a Montreal Cognitive Assessment (MoCA) score lower than 26. MetS was established based on National Cholesterol Education Program Adult Treatment Panel guidelines. Unadjusted and multivariable log‐binomial regression were used to assess the MetS‐CI association, with modification assessment by age, sex, education, cardiorespiratory fitness (CRF), and apolipoprotein‐ε4 carrier status (APOE‐ε4).
RESULTS
MetS was not associated with CI when adjusting for age, sex, minority status, education, and marital status (prevalence ratio [PR] = 1.09; 95% confidence interval = .97‐1.23) or when additionally adjusting for body mass index, CRF, alcohol consumption, current smoking status, and APOE‐ε4 (PR = 1.07; 95% confidence interval = .80‐1.45). The association was not modified by age, sex, CRF, or APOE‐ε4 (P for interaction >.05).
CONCLUSION
In contrast with some global and US studies, MetS and CI were not associated among our study population of nondemented older US adults. MetS may not be a suitable intervention target for poor cognitive outcomes among high socioeconomic older US adults, although separate MetS components may have different recommendations. Future studies should explore more diverse older US populations. If replicated, these findings would inform clinical efforts to reduce the burden of poor cognitive outcomes in the United States.</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><pmid>30854644</pmid><doi>10.1111/jgs.15836</doi><tpages>7</tpages></addata></record> |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adults Age Aged Apolipoprotein E apolipoprotein‐ε4 Body mass index Cardiorespiratory fitness Cholesterol Cognitive ability Cognitive Dysfunction - epidemiology cognitive impairment Confidence intervals Cross-Sectional Studies Dementia Dementia disorders Female Genetic factors Humans Male Mental Status and Dementia Tests Metabolic syndrome Metabolic Syndrome - epidemiology Middle Aged Population studies Prospective Studies Risk factors Sex Smoking Social Class Texas - epidemiology United States - epidemiology |
| title | Metabolic Syndrome and Cognitive Impairment among High Socioeconomic, Nondemented Older US Adults |
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