Metabolic Syndrome and Risk for Incident Alzheimer's Disease or Vascular Dementia
The Three-City Study
Christelle Raffaitin , MD 1 2 ,
Henri Gin , MD, PHD 1 ,
Jean-Philippe Empana , MD, PHD 3 ,
Catherine Helmer , MD, PHD 2 ,
Claudine Berr , MD, PHD 4 ,
Christophe Tzourio , MD, PHD 5 ,
Florence Portet , MD 4 ,
Jean-François Dartigues , MD, PHD 2 ,
Annick Alpérovitch , MD, PHD 5 and
Pascale Barberger-Gateau , MD, PHD 2
1 Diabetology-Nutrition Unit, University Hospital of Bordeaux, Pessac, France
2 Institut National de la Santé et de la Recherche Medicalé (INSERM), U897, Bordeaux, France, Victor Segalen Bordeaux University,
Bordeaux, France
3 INSERM, U909, Paris V University, Paris Sud University, Villejuif, France
4 INSERM, U888, Montpellier, France, Montpellier 1 University, Montpellier, France, University Hospital of Montpellier, Centre
Mémoire de Ressource et de Recherche Languedoc, Rousillon, France
5 INSERM, U708, Paris, France
Corresponding author: C. Raffaitin, christelle.raffaitin{at}isped.u-bordeaux2.fr
Abstract
OBJECTIVE —Associations between metabolic syndrome and its individual components with risk of incident dementia and its different subtypes
are inconsistent.
RESEARCH DESIGN AND METHODS —The 7,087 community-dwelling subjects aged ≥65 years were recruited from the French Three-City (3C) cohort. Hazard ratios
(over 4 years) of incident dementia and its subtypes (vascular dementia and Alzheimer's disease) and association with metabolic
syndrome (defined according to the National Cholesterol Education Program Adult Treatment Panel III criteria) and its individual
components (hypertension, large waist circumference, high triglycerides, low HDL cholesterol, and elevated fasting glycemia)
were estimated in separate Cox proportional hazard models.
RESULTS —Metabolic syndrome was present in 15.8% of the study participants. The presence of metabolic syndrome increased the risk
of incident vascular dementia but not Alzheimer's disease over 4 years, independent of sociodemographic characteristics and
the apolipoprotein (apo) Eε4 allele. High triglyceride level was the only component of metabolic syndrome that was significantly
associated with the incidence of all-cause (hazard ratio 1.45 [95% CI 1.05–2.00]; P = 0.02) and vascular (2.27 [1.16–4.42]; P = 0.02) dementia, even after adjustment of the apoE genotype. Diabetes, but not impaired fasting glycemia, was significantly
associated with all-cause (1.58 [1.05–2.38]; P = 0.03) and vascular (2.53 [1.15–5.66]; P = 0.03) dementia.
CONCLUSIONS —The observed relation between high triglycerides, diabetes, and vascular dementia emphasizes the need for detection and treatment
of vascular risk factors in older individuals in order to prevent the likelihood of clinical dementia.
Footnotes
Published ahead of print at http://care.diabetesjournals.org on 22 October 2008.
Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work
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Metabolic Syndrome and Risk for Incident Alzheimer's Disease or Vascular Dementia

10.2337/dc08-0272