Viscogliosi Giovanni, Donfrancesco Chiara, Palmieri Luigi, Giampaoli Simona
Department of Epidemiology, Surveillance and Promotion of Health, National Institute of Health, Rome, Italy; Department of Gerontology, Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, Sapienza University, Rome, Italy.
Department of Epidemiology, Surveillance and Promotion of Health, National Institute of Health, Rome, Italy.
Arch Gerontol Geriatr. 2017 May-Jun;70:62-66. doi: 10.1016/j.archger.2016.12.008. Epub 2017 Jan 3.
To describe longitudinal relationships of metabolic syndrome (MetS) to cognitive decline and functional disability in a sample of older non-institutionalized men.
data from 1991 to 2000 of the Italian cohorts of the Finland, Italy, the Netherlands, Elderly (FINE) study, were used. Global cognitive function and functional disability, defined as limitations in mobility, basic (ADLs) and instrumental activities of daily living (IADLs) were screened in 1991 and 2000. MetS was defined according to the NCEP ATP-III criteria.
The study sample consisted of 195 men, baseline age 76.1±3.1years. Baseline MetS was prospectively associated with greater 10-year cognitive and functional decline in ADLs and IADLs. After multiple adjustment including age, education, marital status, ApoE ε4 allele, cerebrovascular disease and initial cognitive and depressive status, MetS predicted cognitive decline (B=-1.684, 95%CI=-2.202 to -1.167, p<0.001) and risk of IADLs (OR=1.09, 95% CI=1.01-1.20, p=0.048) and ADLs disability (OR=1.35, 95%CI=1.12-1.62, p<0.001). Interestingly, such associations were not attributable to individual altered components of MetS nor to their sum. Incident disability in ADLs and IADLs were not explained by parallel decline in cognitive function.
MetS as an entity was associated with accelerated cognitive and functional decline in a population-based sample of very old men.
描述非机构化老年男性样本中代谢综合征（MetS）与认知衰退及功能残疾之间的纵向关系。
使用了芬兰、意大利、荷兰老年（FINE）研究中意大利队列1991年至2000年的数据。1991年和2000年对全球认知功能以及定义为行动能力受限、基本日常生活活动（ADL）和工具性日常生活活动（IADL）受限的功能残疾进行了筛查。MetS根据美国国家胆固醇教育计划成人治疗组第三次报告（NCEP ATP-III）标准进行定义。
研究样本包括195名男性，基线年龄为76.1±3.1岁。基线时的MetS与ADL和IADL中10年更大程度的认知和功能衰退存在前瞻性关联。在进行包括年龄、教育程度、婚姻状况、载脂蛋白Eε4等位基因、脑血管疾病以及初始认知和抑郁状态的多重调整后，MetS可预测认知衰退（B=-1.684，95%置信区间=-2.202至-1.167，p<0.001）以及IADL风险（比值比=1.09，95%置信区间=1.01-1.20，p=0.048）和ADL残疾风险（比值比=1.35，95%置信区间=1.12-1.62，p<0.001）。有趣的是，这些关联并非归因于MetS的个体改变成分，也不是其总和。ADL和IADL中的新发残疾无法通过认知功能的平行衰退来解释。
在基于人群的高龄男性样本中，MetS作为一个整体与认知和功能衰退加速相关。
