Association of Metabolic Syndrome With Incident Dementia: Role of Number and Age at Measurement of Components in a 28-Year Follow-up of the Whitehall II Cohort Study

Marcos D Machado-Fragua (1) , Aurore Fayosse (1) , Manasa Shanta Yerramalla (1) , Thomas T van Sloten (2) , Adam G Tabak (3, 4) , Mika Kivimaki (4) , Séverine Sabia (1, 4) , Archana Singh-Manoux (1, 4)

1 EpiAgeing [CRESS - U1153 / UMR_A 1125] - Epidemiology of Ageing and Neurodegenerative diseases
2 CARIM - Cardiovascular Research Institute Maastricht
3 Semmelweis University of Medicine [Budapest]
4 UCL - University College of London [London]

OBJECTIVE : Previous research suggests an inconsistent association between Metabolic syndrome (MetS) and incident dementia. We examined the role of number of MetS components and age at their assessment for incident dementia. RESEARCH DESIGN AND METHODS : MetS components (fasting glucose, triglycerides, waist circumference, blood pressure, and HDL cholesterol) on 7,265, 6,660, and 3,608 participants at <60, 60 to <70, and ≥70 years of age were used to examine associations with incident dementia using cause-specific Cox regression. RESULTS : Analyses of MetS measured at <60, 60 to <70, and ≥70 years involved 393 (5.4%), 497 (7.5%), and 284 (7.9%) dementia cases over a median follow-up of 20.8, 10.4, and 4.2 years, respectively. Every additional MetS component before 60 (hazard ratio [HR] 1.13 [95% CI 1.05, 1.23]) and 60 to <70 (HR 1.08 [95% CI 1.00, 1.16]) but not ≥70 years (HR 1.04 [95% CI 0.96, 1.13]) was associated with higher dementia risk. MetS defined conventionally (≥3 components) before 60 years (HR 1.23 [95% CI 0.96, 1.57]), between 60 and 70 years (HR 1.14 [95% CI 0.91, 1.42]), or >70 years of age (HR 1.10 [95% CI 0.86, 1.40]) was not associated with incident dementia. Multistate models showed higher risk of dementia in those with ≥1 (HR 1.99 [95% CI 1.08, 3.66]) and ≥2 MetS components (HR 1.69 [95% CI 1.12, 2.56]) before 60 years of age, even when they remained free of cardiovascular disease over the follow-up. CONCLUSIONS : Risk of incident dementia increases with every additional MetS component present in midlife rather than after accumulation of three components; only part of this risk is mediated by cardiovascular disease.

Mots clés: metabolic syndrome; dementia; abdominal obesity; hdl cholesterol; triglycerides; hypertension; fasting glucose

Domaines: Sciences du Vivant [q-bio]

Marcos D Machado-Fragua, Aurore Fayosse, Manasa Shanta Yerramalla, Thomas T van Sloten, Adam G Tabak, et al.. Association of Metabolic Syndrome With Incident Dementia: Role of Number and Age at Measurement of Components in a 28-Year Follow-up of the Whitehall II Cohort Study. Diabetes Care, 2022, ⟨10.2337/dc22-0206⟩. ⟨hal-03722244⟩