P4-126: Metabolic syndrome, successful and pathological neuroaging in a stroke-free elderly population

Large part of the age-related neurofunctional decline is associated with stroke and cerebral microangiopathy. Metabolic Syndrome (Met.S) is a risk factor for both of these cerebrovascular disorders. It is unknown if Met.S is associated with neurofunctional decline in a stroke-free population. We evaluated 422 healthy community-dwelling elderly (≥ 60) in Brazil. Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS), ‘Up&Go' and Functional Reach tests, Executive Function and Activities of Daily Living were assessed. All reported values have P < 0.05. Met.S was present in 39.3% of the subjects. Neurofunctional scores were significantly lower in the Met.S than in the control group (F: 2.7–5.9). Age alone explained 47% of all MMSE variance in the Met.S group, but just 12.8% among controls (P < 0.001 for difference). Age accounted for 18.7% of the variance on GDS in the Met.S group, whereas GDS score was not related to age in the control group. Analogously, the control group tended to have a more homogeneous score through all ages for every variable, whereas the Met.S group tended to have lower performances with increasing age (P < 0.05 for all differences). Adjusting for individual Met.S components reduced the power of the correlations between the number of Met.S components and evaluated neurofunctional scores (from R: 0.130–0.227 to R: 0.101–0.183), but did not eliminate their statistical significances, evidencing a synergism. The strong inverse correlation between the MMSE and GDS scales was restricted to the Met.S group (B: 0.38; P ≤ 0.001). Met.S was independently associated with lower cognitive, executive, neuromotor and functional scores, and with more depressive symptoms. Association between cognitive dysfunction and depressive symptoms were explained in terms of Met.S-associated cerebrovascular risk. Met.S might be a major determinant of ‘successful' or ‘pathological' neuroaging in western societies.