A Comparative Analysis of The Impact of Metabolic Syndrome on Cognitive Functions in Middle-Aged Adults According to NCEP ATP III and WHO Criteria

Objective: Studies have highlighted the adverse effects of metabolic syndrome (MetS), a cluster of cardiovascular disease risk factors, on cognitive functions.This study aimed to explore early cognitive function changes in middle-aged patients recently diagnosed with MetS and to compare the sensitivity of the ATP III and World Health Organization (WHO) criteria in relation to cognitive functions. Methods:This cross-sectional study included 64 participants, 39 patients with MetS according to ATP III criteria and 25 healthy controls matched for age, sex and education.Of the 39 MetS patients, 30 also met the WHO criteria.Metabolic parameters and neuropsychological assessments were compared between the MetS and control groups according to both criteria.Results: According to ATP III criteria, central obesity is the most common criterion in MetS patients, while in WHO criteria, it comes after the mandatory criterion of insulin resistance.Control patients did not meet any MetS criteria.The findings showed that MetS patients classified according to ATP III had significant impairments in attention (digit span test, p=0.042), executive functions (Stroop color test, p=0.048; word fluency, p=0.024; similarity test, p=0.001), memory (logical memory, p=0.001; visual memory, p=0.001; immediate recall, p=0.001; delayed recall, p=0.011), and learning (p=0.001).In contrast, MetS patients classified according to WHO showed impairments mainly in executive functions (word fluency, p=0.022; similarity test, p=0.001), memory (logical memory, p=0.007; visual memory, p=0.002; immediate recall, p=0.003), and learning (p=0.001). Conclusion:MetS is linked to impairments in attention, executive functions, memory, and learning abilities in middle-aged individuals, even at the early stages of the condition.Defining MetS according to the ATP III criteria might said to be more sensitive for assessing cognitive decline, as it identifies deficits across a wider range of cognitive domains compared to the WHO criteria.