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A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
Published on: January 11, 2020
Metabolic syndrome, inflammation, and nonamnestic mild cognitive impairment in older persons: a population-based
Rosebud O Roberts1, Yonas E Geda, David S Knopman
1Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA. roberts.rosebud@-mayo.edu
Abstract:
The metabolic syndrome (MetS) is more strongly associated with cognitive impairment in the presence of inflammation. This suggests that the association of MetS with mild cognitive impairment (MCI) may vary with the etiology and the subtype of MCI. This study investigated the association between MetS with or without inflammation and MCI [amnestic (a-MCI) and nonamnestic (na-MCI)]. We studied a randomly selected sample of 1969 participants (ages 70 to 89 y) from Olmsted County, MN, using the Clinical Dementia Rating Scale, a neurologic evaluation, and neuropsychologic testing. Data for participants were reviewed for a diagnosis of normal cognition, MCI, or dementia. Clinical components of MetS were ascertained by interview and confirmed from the medical records; biochemical measurements were assayed from a blood draw. We compared 88 na-MCI cases and 241 a-MCI cases with 1640 cognitively normal participants. MetS was not associated with either na-MCI or a-MCI. High C-reactive protein (CRP; highest tertile vs lowest tertile) was associated with na-MCI [odds ratio (OR)=1.85; 95% confidence interval (CI)=1.05, 3.24] but not with a-MCI, after adjusting for sex, age, and years of education. The combination of MetS and high CRP (compared to no MetS and lowest CRP tertile) was associated with na-MCI (OR=2.31; 95% CI=1.07, 5.00), but not with a-MCI (OR=0.96; 95% CI=0.59, 1.54). The combined presence of MetS and high levels of inflammation is associated with na-MCI in this elderly cohort, and suggests etiologic differences in MCI subtypes.
Insights
Metabolic syndrome (MetS) combined with inflammation is linked to nonamnestic mild cognitive impairment (na-MCI) in older adults. This suggests inflammation plays a key role in specific types of cognitive decline.
Area of Science:
- Neurology
- Gerontology
- Internal Medicine
Background:
- Metabolic syndrome (MetS) is increasingly recognized for its association with cognitive impairment.
- The interplay between MetS, inflammation, and different subtypes of mild cognitive impairment (MCI) requires further investigation.
- Understanding these relationships is crucial for identifying specific risk factors and potential interventions for cognitive decline in aging populations.
Purpose of the Study:
- To investigate the association between metabolic syndrome (MetS), with and without inflammation, and mild cognitive impairment (MCI).
- To differentiate the impact of MetS and inflammation on amnestic MCI (a-MCI) versus nonamnestic MCI (na-MCI).
- To explore potential etiologic differences between MCI subtypes based on metabolic and inflammatory profiles.
Main Methods:
- A randomly selected cohort of 1969 participants aged 70-89 years was studied.
- Participants underwent neurologic evaluation, neuropsychologic testing, and biochemical assays for inflammation markers like C-reactive protein (CRP).
- Diagnoses included normal cognition, MCI (a-MCI and na-MCI), and dementia; MetS components were clinically ascertained and biochemically confirmed.
Main Results:
- Metabolic syndrome (MetS) alone was not significantly associated with either nonamnestic MCI (na-MCI) or amnestic MCI (a-MCI).
- High C-reactive protein (CRP) levels were associated with na-MCI but not a-MCI.
- The combination of MetS and high CRP was significantly associated with na-MCI, but not with a-MCI.
Conclusions:
- The combined presence of metabolic syndrome and high inflammation is specifically associated with nonamnestic mild cognitive impairment in the elderly.
- These findings suggest distinct underlying etiologies for different subtypes of mild cognitive impairment.
- Inflammation appears to be a critical factor mediating the relationship between MetS and specific forms of cognitive impairment.
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