Current Epidemiological Approaches to the Metabolic-Cognitive Syndrome

Issue title: Metabolic-Cognitive Syndrome: Update on the Metabolic Pathway in Neurodegenerative Disorders

Guest editors: Vincenza Frisardi and Bruno Imbimbo

Article type: Review Article

Authors: Panza, Francesco^{a; *} | Solfrizzi, Vincenzo^b | Logroscino, Giancarlo^c | Maggi, Stefania^d | Santamato, Andrea^e | Seripa, Davide^a | Pilotto, Alberto^{a; f}

Affiliations: [a] Geriatric Unit and Gerontology-Geriatrics Research Laboratory, Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy | [b] Department of Geriatrics, Center for Aging Brain, Memory Unit, University of Bari, Bari, Italy | [c] Department of Neurological and Psychiatric Sciences, University of Bari, Bari, Italy | [d] Italian National Research Council (CNR), Aging Section, Padova, Italy | [e] Department of Physical Medicine and Rehabilitation-“OORR Hospital”, University of Foggia, Foggia, Italy | [f] Geriatrics Unit, Azienda ULSS 16 Padova, S Antonio Hospital, Padova, Italy

Correspondence: [*] Correspondence to: Francesco Panza, M.D., Ph.D., Geriatric Unit and Gerontology-Geriatric Research Laboratory, IRCCS Casa Sollievo della Sofferenza, Viale Cappuccini 1, 71013 San Giovanni Rotondo, Foggia, Italy. E-mails: geriat.dot@geriatria.uniba.it, f.panza@operapadrepio.it.

Abstract: In the last decade, cumulative epidemiological evidence suggested that vascular- and metabolic-based risk factors may be important in the development of mild cognitive impairment and dementia. Epidemiological and basic research have also proposed a model of cognitive impairment linked to metabolic syndrome (MetS) and metabolic disorders, suggesting for research purposes a “metabolic-cognitive syndrome” (MCS) in patients with MetS plus cognitive impairment of degenerative or vascular origin. In particular, MetS has been associated with the risk of age-related cognitive decline and vascular dementia, but contrasting findings also existed on the possible role of MetS in overall dementia and Alzheimer's disease. Among metabolic determinants of cognitive impairment, a better approach to the understanding of mechanisms could be to hypothesize a continuum leading to various degrees of late-life cognitive disorders in older subjects with metabolic-based risk factors. The MCS model could help us to explain the complex relationship between metabolic disorders and cognitive disturbances and the boundaries between normal and pathological conditions, with a better understanding of clinical and neuropathological features of these metabolic-based cognitive disorders. Strategies toward early and effective risk factor management could be of value in reducing the risk of MCS, so delaying the onset or preventing the progression of predementia syndromes. In the near future, clinical trials could be undertaken to determine if addressing MetS and metabolic-based risk factors, including inflammation, through lifestyle modification holds out the possibility of slowing down or ameliorating the cognitive aging process itself.

Keywords: Alzheimer's disease, body mass index, dementia, diabetes mellitus, frailty, HDL cholesterol, hypertension, hypertriglyceridemia, insulin resistance, metabolic syndrome, mild cognitive impairment, obesity, predementia syndromes, vascular dementia, vascular risk factors

DOI: 10.3233/JAD-2012-111496

Journal: Journal of Alzheimer's Disease, vol. 30, no. s2, pp. S31-S75, 2012