Abstract
This study investigated the effects of changes in metabolic syndrome (MS) status and each component on subsequent dementia occurrence. The study population was participants of a biennial National Health Screening Program in 2009–2010 and 2011–2012 in Korea. Participants were divided into four groups according to change in MS status during the two-year interval screening: sustained normal, worsened (normal to MS), improved (MS to normal), and sustained MS group. Risk of dementia among the groups was estimated from the second screening date to 31 December 2016 using a Cox proportional hazards model. A total of 4,106,590 participants were included. The mean follow-up was 4.9 years. Compared to the sustained normal group, adjusted hazard ratios (aHR) (95% confidence interval) were 1.11 (1.08–1.13) for total dementia, 1.08 (1.05–1.11) for Alzheimer’s disease, and 1.20 (1.13–1.28) for vascular dementia in the worsened group; 1.12 (1.10–1.15), 1.10 (1.07–1.13), and 1.19 (1.12–1.27) for the improved group; and 1.18 (1.16–1.20), 1.13 (1.11–1.15), and 1.38 (1.32–1.44) for the sustained MS group. Normalization of MS lowered the risk of all dementia types; total dementia (aHR 1.18 versus 1.12), Alzheimer’s disease (1.13 versus 1.10), and vascular dementia (1.38 versus 1.19). Among MS components, fasting glucose and blood pressure showed more impact. In conclusion, changes in MS status were associated with the risk of dementia. Strategies to improve MS, especially hyperglycemia and blood pressure, may help to prevent dementia.
Highlights
With populations aging worldwide, the number of people with dementia is steadily increasing
Dementia occurrence risk was higher in the metabolic syndrome (MS) group after adjustment for age, sex, smoking, alcohol, regular exercise, stroke, depression, and chronic kidney disease (CKD) (Model 2) (adjusted hazard ratio, 1.12; 95% confidence intervals (95% CIs), 1.11–1.14)
MS was more strongly associated with vascular dementia (VD) than Alzheimer’s disease (AD)
Summary
The number of people with dementia is steadily increasing. In 2015, the estimate of people with dementia was 47.47 million and the number is expected to reach 75.63 million in 2030 and 135.46 million in 2050 [1]. Dementia is a leading chronic disease that contributes to disability. Worldwide costs of dementia are high [2]. Considerable effort has been invested in preventing and curing dementia. No significant preventative or therapeutic drugs have been developed yet. Acetylcholine esterase inhibitors and N-methyl-D-aspartate (NMDA) receptor antagonists have been used, they only slow the progression of dementia and cannot cure the disease. At present, the most important way to manage dementia is to find and control risk factors to prevent the disease
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