Cognitive Performance in Individuals With Changes in Metabolic Syndrome Status in the Lifelines Cohort Study

Abstract

Introduction: Metabolic syndrome was found to be associated with increased risk of dementia. Although, findings on how the dynamic alterations in metabolic syndrome status affect cognition, also in presence of established risk factors such as smoking, remain controversial. This study investigates whether individuals with different changes in metabolic syndrome status differ in cognitive functioning and whether ever being a smoker affects these possible differences. Methods: 22198 Lifelines participants (61.6 years (SD 6.5), 12373 (55.7%) women) were divided into four groups based on the change in their metabolic syndrome status at two time points: without metabolic syndrome (n = 16319; - -), metabolic syndrome improved (n = 2041; + -), metabolic syndrome de novo (n = 1275; - +), persistent metabolic syndrome (n = 2563; + +).ANCOVA models were run to analyze group differences in cognitive performance measured by the Cogstate Brief Battery. Additional ANCOVAs were run in subgroups of non-smokers and ever smokers. Results: Accounting for education, age, sex, and time interval between examinations, participants with persistent metabolic syndrome had lower cognitive functioning compared to those without metabolic syndrome, those with improved metabolic syndrome, and those with de novo metabolic syndrome. These differences disappear when only considering non-smokers, but remain in the ever smokers subgroup. Discussion: Persistent metabolic syndrome affects performance in psychomotor function, visual attention, and visual learning in participants aged ≥ 50. This is only the case for individuals with persistent metabolic syndrome that have ever been smokers. Strategies aimed at the cure of metabolic syndrome, especially in ever smokers, might benefit cognition and slow down cognitive decline.