Metabolic syndrome (MetS) affects cognitive function in late-life, particularly in women. But longitudinal research is scarce on associations of MetS with cognitive function during midlife.
Objective was to determine associations between MetS exposure and cognitive function trajectories in midlife women.
This is a 17-year prospective, longitudinal study of multi-racial/ethnic women in seven US communities, with annual/biennial assessments.
Participants were 2,149 US women traversing menopause.
Exposure consisted of MetS assessments (median four assessments over four years).
Main outcome measures were assessments of cognitive function in 3 domains: perceptual speed (Symbol Digit Modalities Test, SDMT), episodic memory (East Boston Memory Test), and working memory (Digit Span Backward Test).
By their first cognitive assessment (age 50.7±2.9 years), 29.5% met the criteria for MetS. Women completed a median (IQR) of 6 (IQR 4-7) follow-up cognitive assessments over 11.2 (IQR 9.2-11.5) years. Women with MetS, compared to those without, had a larger 10-year decline in SDMT z-score (estimate -0.087, 95%CI -0.150, -0.024, p=0.007), after adjustment for cognitive testing practice effects, sociodemographic, lifestyle, mood and menopause factors. As such, MetS accelerated the 10-year loss of perceptual speed by 24%. MetS did not differentially affect the rate of decline in either immediate (p=0.534) or delayed (p=0.740) episodic memory or in working memory (p=0.584).
In midlife women MetS exposure was associated with accelerated decline in perceptual speed, but not episodic or working memory.

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