| Background and Purpose:Dementia,one of the important causes of death and disability,has become a worldwide health problem which seriously affects the ability of daily life of patients and reduces the quality of life.Currently,vascular risk factors,including hypertension,dyslipidemia,diabetes and obesity have become a major focus of research.In addition,lifestyle factors such as smoking,alcohol consumption,physical activity,diet and nutrition have also been shown to be associated with dementia.Metabolic syndrome is a group of metabolic disorders commonly found in the human population,consisting of a variety of vascular risk factors,including abdominal obesity,elevated blood pressure,elevated blood sugar levels,reduced HDL cholesterol levels and elevated triglyceride levels.A large number of studies have shown that metabolic syndrome(MetS)is associated with decreased cognitive function.However,the results of previous studies were inconsistent,and questions about the association between the components of the metabolic syndrome and cognitive impairment as well as the cognitive subdomains remain to be explored.The purpose of this study was to investigate the relationship between metabolic syndrome,each of its 5 components and dementia in elderly population in rural areas of Shandong Province through baseline survey and data analysis.Objects:A total of 5122 elderly people from the Multi-model Intervention Study for Dementia Delaying in Rural China(Mind-China)project were enrolled in this study,including 1936(37.80%)with metabolic syndrome and 297(5.80%)with dementia.Methods:In this study,baseline data were collected from 52 villages in Yanlou Town,Yanggu County,Liaocheng City,Shandong Province from March 2018 to September 2018 through physical examination,face-to-face interview,neuropsychological test,cognitive function assessment and blood sample analysis.The cognitive assessment included global cognitive function assessment and subdomain scales such as memory,language,attention and execution.The study population was classified as dementia group and non-dementia group by cognitive function.Data analysis was conducted using statistical software.Results:1.After adjusting for all the covariates,the risk of dementia in metabolic syndrome group was higher than that in non-metabolic syndrome group(OR=1.73,P=0.001).Among the five components,elevated blood glucose and triglycerides were associated with a significantly increased risk of dementia compared with those without these risk factors(OR=1.41,P=0.009;OR=1.43,P=0.013).2.Compared to non-MetS group(x=20.83,SD=0.113),the MetS group(x=20.01,SD=0.145)has a lower MMSE score.MMSE scores were significantly lower in the central obesity group(x=21.53,SD=0.158),the elevated blood pressure group(x=20.06,SD=0.107),the elevated triglyceride group(x=20.71,SD=0.104)and the low HDL cholesterol group(x=20.65,SD=0.093)than in the groups without these risk factors(P<0.001,P=0.046,P=0.001,P<0.001).3.The MetS group did not show any difference in the scores of each subcognitive domain compared with the non-MetS syndrome group after adjusting for all the relevant covariates(P=0.393).Among all components,central obesity was significantly correlated with MMSE score and attentional subcognitive domain(β=0.427,P=0.01;β=0.079,P=0.01),and the MMSE score and the Z-score of the attention subcognitive domain increased with the increase of waist circumference.At the same time,blood pressure was significantly correlated with language(β=-0.065,P=0.036)and executive(β=-0.063,P=0.040)subdomain scores and both subcognitive scores decreased with the increase of blood pressure.Other components did not show significant correlations with subcognitive domains and MMSE scores.Conclusion:In this study,we found that metabolic syndrome and two of its components,fasting glucose and triglyceride,were significantly associated with the occurrence of dementia in rural elderly population in Shandong,and metabolic syndrome was an independent risk factor for cognitive dysfunction.In addition,the individual effects of each component of the metabolic syndrome on the subcognitive domain were mainly related to central obesity and elevated blood pressure. |
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