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Metabolic syndrome may hasten 'neuroaging'.

Mid-Atlantic Bureau

CHICAGO--Older people with metabolic syndrome are significantly more likely to experience depression and deficits in cognition and function as they age than are their healthier peers.

The presence of metabolic sydrome explained up to 34% of the age-related declines that Dr. Matheus Roriz-Cruz observed in a prospective study. "The results of this study reinforce the importance of maintaining good physical health in order to reduce the risk of experiencing cognitive decline," he said at the International Conference on Alzheimer's disease.

The study included 422 older, community-living subjects aged 60 years and older. Most of the subjects (256) did not have metabolic syndrome. No significant difference was found in socioeconomic status. years of education, alcohol and tobacco use, heart disease, or stroke. However, significantly more of those without metabolic syndrome were actively employed (67% vs. 55%) and engaged in regular exercise (41% vs. 19%).

Dr. Roriz-Cruz of the Federal University of Rio Grande do Sul State, Porto Alegre, Brazil, and his colleagues used six measures to evaluate mental and physical health: the Mini-Mental State Examination (MMSE), Geriatric Depression Scale, activities of daily living, executive function, the timed "Up and Go" test, and functional reach. In all of these measures those without metabolic syndrome scored significantly higher than did those with the disorder throughout the spectrum of ages included in the study.

On all measures, both groups showed an age-related pattern of decline. But the decline was significantly steeper among those with metabolic syndrome.

Age alone explained 47% of the MMSE score variance in the metabolic syndrome group, but just 13% among controls. Similarly, while depression scores were not related to age at all in the control group, age accounted for 19% of the variance on the Geriatric Depression Scale in the metabolic syndrome group. On balance, age accounted for 3% of the control group's decline and 11% of the decline in the metabolic syndrome group. On executive function-directed activities of daily living, age accounted for 7% of the control group's decline, but 14% of the decline seen in those with metabolic syndrome.

"The mean scores in the neurofunctional tests worsened much more with increasing age in the metabolic syndrome group," Dr. Roriz-Cruz said in an interview. "This might mean that people with metabolic syndrome age faster, not only in terms of vascular aging [as is already known], but also in terms of 'neuroaging.'"

The possibility that those with metabolic syndrome age faster makes sense considering that caloric restriction seems to slow the process of aging in mice, chimpanzees, and humans, he said. "Both metabolic syndrome and caloric restriction seem to be associated with peripheral insulin sensitivity.

"What should doctors say to their patients? Simply that we are realizing that exercise and healthy eating are not only good for the health of the body but also for the health of the brain. It is not a difficult concept to understand, but it is a difficult concept tot be put into practice."
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Title Annotation:Endocrinology
Author:Sullivan, Michele G.
Publication:Internal Medicine News
Article Type:Clinical report
Geographic Code:1USA
Date:Oct 1, 2008
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