Cognitive impairment and frontal-subcortical geriatric syndrome are associated with metabolic syndrome in a stroke-free population

Background Metabolic syndrome (Met.S) consists of a conglomeration of obesity, hypertension, glucose intolerance, and dislipidemia. Frontal-subcortical geriatric syndrome (FSCS) is caused by ischemic disruption of the frontal-subcortical network. It is unknown if Met.S is associated with FSCS. Methods We evaluated 422 community-dwelling elderly (≥60) in Brazil. FSCS was defined as the presence of at least one frontal release sign (grasping, palmomental, snout, or glabellar) plus coexistence of ≥3 the following criteria: (1) cognitive impairment, (2) late-onset depression, (3) neuromotor dysfunction, and (4) urgency incontinence. All values were adjusted to age and gender. Results Met.S was present in 39.3% of all subjects. Cases without any of the FSCS components represented 37.2% (‘successful neuroaging’ group). People with 1–3 of the FSCS components (‘borderline pathological neuroaging’ group) were majority (52.6%), whereas those with 4–5 of these components (FSCS group) were minority (10.2%). Met.S was significantly associated with FSCS (OR = 5.9; CI: 1.5–23.4) and cognitive impairment (OR = 2.2; CI: 1.1–4.6) among stroke-free subjects. Number of Met.S components explained 30.7% of the variance on the number of FSCS criteria (P < 0.001). If Met.S were theoretically removed from this population, prevalence of FSCS would decline by 31.6% and that of cognitive impairment by 21.4%. Conclusions Met.S was significantly associated with a 5.9 and 2.2 times higher chance of FSCS and cognitive impairment, respectively. Met.S might be a major determinant of ‘successful’ or ‘pathological’ neuroaging in western societies.