Metabolic Syndrome and Cognitive Impairment: Current Epidemiology and Possible Underlying Mechanisms

Article type: Review Article

Authors: Panza, Francesco^a | Frisardi, Vincenza^b | Capurso, Cristiano^c | Imbimbo, Bruno P.^d | Vendemiale, Gianluigi^c | Santamato, Andrea^e | D'Onofrio, Grazia^a | Seripa, Davide^a | Sancarlo, Daniele^a | Pilotto, Alberto^a | Solfrizzi, Vincenzo^{b; *}

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 Geriatrics, University of Foggia, Foggia, Italy | [d] Research & Development Department, Chiesi Farmaceutici, Parma, Italy | [e] Department of Physical Medicine and Rehabilitation-“OORR Hospital”, University of Foggia, Italy

Correspondence: [*] Correspondence to: Vincenzo Solfrizzi, M.D., Ph.D., Department of Geriatrics, Center for Aging Brain, Memory Unit, University of Bari, Policlinico, Piazza Giulio Cesare, 11 – 70124 Bari, Italy. Tel.: +39 080 5473685; Fax: +39 080 5478860; E-mail: v.solfrizzi@geriatria.uniba.it.

Abstract: A possible role of vascular and lifestyle-related factors was recently proposed for age-related changes of cognitive function, predementia syndromes, and cognitive decline of degenerative (Alzheimer's disease, AD) or vascular origin (vascular dementia, VaD). At present, cumulative evidence suggests that vascular risk factors may be important in the development of mild cognitive impairment (MCI), dementia, and AD. Among vascular-related factors, metabolic syndrome (MetS) has been associated with the risk of cognitive decline, overall dementia, and VaD, but contrasting findings also existed on the possible role of MetS in AD. If MetS is associated with increased risk of developing cognitive impairment, regardless of mechanism, then early identification and treatment of these individuals at risk might offer new avenues for disease-course modification. Strategies towards early and effective risk factor management could be of value in reducing risk of metabolic and cognitive decline. Future research is needed to confirm the association between MetS and cognitive impairment and to determine the exact mechanism linking them. Such would provide important insights into the causes and interdependencies of predementia and dementia syndromes, and inspire novel strategies for treating and preventing these disorders. At present, vascular risk factor and MetS management could be employed to delay the onset of dementia syndromes or to prevent the progression of predementia syndromes. In the future, trials could be undertaken to determine whether modifications of these risk factors, including inflammation, could lower risk of developing cognitive decline.

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

DOI: 10.3233/JAD-2010-091669

Journal: Journal of Alzheimer's Disease, vol. 21, no. 3, pp. 691-724, 2010