Association Between Metabolic Syndrome Severity and Cognitive Function in Adults: A Cross-Sectional Study

Background: Metabolic syndrome (MetS) is a cluster of metabolic abnormalities, including central obesity, hypertension, hyperglycaemia, hypertriglyceridaemia and low level of high-density lipoprotein cholesterol (HDL-C) that are linked to higher cardiovascular and metabolic risk. Recent studies have shown that metabolic syndrome could have detrimental effects on cognition via vascular, inflammatory and metabolic pathways. The aim of the present study was therefore to assess if there was any relationship between worsening metabolic syndrome and cognitive function among adults. Material and Methods: The present study was cross sectional and observational study among adults aged 25-65 years having metabolic syndrome in a tertiary care centre of Bareilly, Uttar Pradesh, India. The criteria used for the diagnosis of metabolic syndrome were modified NCEP ATP III criteria. All the anthropometric measurements, blood pressure, fasting blood glucose, triglycerides, and HDL-C were evaluated according to standard methods. The Hindi version of Mini Mental State Examination (HMSE) was used to assess cognitive function. Spearman correlation was used to determine the relationship of components of metabolic syndrome with MMSE score and Kruskal–Wallis test was used for comparison between groups. Results: Waist circumference, fasting blood glucose, triglycerides, and systolic blood pressure demonstrated significant negative correlations with MMSE score, whereas HDL-C showed a significant positive correlation. A progressive decline in MMSE score was observed with increasing number of metabolic syndrome components (24.10 ± 1.85 in subjects with three components, 22.55 ± 2.46 with four components, and 20.76 ± 3.10 with five components; p <0.001). Mild to moderate cognitive impairment was observed in 49.7% of participants, while severe cognitive impairment was present in 4.7% of subjects. Conclusion: Increasing severity of metabolic syndrome was significantly associated with worsening cognitive function. The findings suggest that cumulative metabolic abnormalities may adversely affect cognition and highlight the importance of early identification and management of metabolic risk factors to reduce cognitive decline.

Keywords: MetS – Metabolic Syndrome; MMSE – Mini-Mental State Examination; HMSE – Hindi Mental State Examination; BMI – Body Mass Index; HDL-C – High Density Lipoprotein Cholesterol; NCEP ATP III – National Cholesterol Education Program Adult Treatment Panel III.