Metabolic syndrome impact on cognitive composites domain scores and on white matter hyperintensities in subjective cognitive decline: The FACEHBI Cohort

• Published in: Alzheimer's & dementia Vol. 17; no. S6
• Main Authors: Ortega, Gemma, Espinosa, Ana, Alegret, Montserrat, Monté‐Rubio, Gemma, Sotolongo‐Grau, Oscar, Sanabria, Angela, Tartari, Juan Pablo, Rodriguez‐Gomez, Octavio, Marquié, Marta, Vivas, Assumpta, Gómez‐Chiari, M, Alarcón‐Martín, Emilio, Pérez‐Cordón, Alba, Roberto, Natalia, Hernandez, Isabel, Rosende‐Roca, Maitee, Vargas, Liliana, Mauleon, Ana, Abdelnour, Carla, Antonio, Ester Esteban‐De, López‐Cuevas, Rogelio, Alonso‐Lana, S, Moreno‐Grau, Sonia, de Rojas, Itziar, Orellana, Adelina, Montrreal, Laura, Tarraga, Lluis, Ruiz, Agustin, Boada, Mercè, Valero, Sergi
• Format: Journal Article
• Language: English
• Published: 01-12-2021
• ISSN: 1552-5260; 1552-5279
• DOI: 10.1002/alz.051324

Background
To explore the impact of Metabolic Syndrome (MetS) and its components on Cognitive Composites (CCs) domain scores and on White Matter Hyperintensities (WMHs) in individuals experiencing Subjective Cognitive Decline (SCD).
Method
Two hundred participants from the FACEHBI cohort underwent structural Magnetic Resonance Imaging (MRI), 18F‐Florbetaben Positron Emission Tomography (FBB‐PET), and a comprehensive neuropsychological assessment. MetS was defined using the Joint Interim Statement of the International Diabetes Federation Task Force on Epidemiology and Prevention criteria (elevated fasting glucose, elevated blood pressure, reduced HDL‐C, elevated triglycerides and elevated waist circumference). WMHs were addressed through the Fazekas scale, the Age‐related white matter changes (ARWMC) scale, and the FreeSurfer pipeline. Ten CCs domain scores were created using principal components analysis (PCA): (1) executive function fluency, (2) executive function processing speed, (3) executive function attention, (4) verbal memory, (5) visual memory, (6) face–name associative memory, (7) face–occupation associative memory, (8) language, (9) visuoperception, and (10) praxis. Age, sex, education, and Apolipoprotein E (APOE) were used as adjusting variables. Several analyses were performed to explore a sex effect.
Result
Forty‐seven individuals matched the MetS criteria. This syndrome behaves differently based on sex. Only women with MetS showed better performance in language (p = .002; OR = 2.12) than those without MetS. The only differentiating component between both groups (presence/absence MetS) was that women in the MetS subgroup presented greater abdominal obesity (Mann‐Whitney p = .001). From Mets group, antihypertensive drug treatment was significantly associated with better praxis scores (p = .012; OR = 1.84) and HDL‐C drug treatment with better language scores but worse episodic memory performance (p = .028; OR = 1.60; and p = .007; OR = .57, respectively). Drug treatment for elevated glucose was associated with low WMH load in the ARWMC scale (β= ‐.144; p = .045).
Conclusion
This study demonstrated a protective effect of MetS in cognitive performance among SCD women with greater abdominal obesity and a lack of association between MetS and WMH load, although further investigation is needed to explore the long term impact of its entity.