Optimizing midlife metabolic syndrome thresholds for dementia: a prospective study of two UK population-based cohorts

Abstract Background The concept of metabolic syndrome (MetS) was developed to identify individuals at higher risk of type 2 diabetes and cardiovascular disease, but its relevance for dementia remains unclear. We examined MetS in midlife for association with late-onset dementia, focusing on the thres...

Full description

Saved in:
Bibliographic Details
Main Authors: Sam Vidil, Archana Singh-Manoux, Benjamin Landré, Aurore Fayosse, Séverine Sabia, Marcos D. Machado-Fragua
Format: Article
Language:English
Published: BMC 2025-04-01
Series:Alzheimer’s Research & Therapy
Subjects:
Online Access:https://doi.org/10.1186/s13195-025-01732-8
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850139261360144384
author Sam Vidil
Archana Singh-Manoux
Benjamin Landré
Aurore Fayosse
Séverine Sabia
Marcos D. Machado-Fragua
author_facet Sam Vidil
Archana Singh-Manoux
Benjamin Landré
Aurore Fayosse
Séverine Sabia
Marcos D. Machado-Fragua
author_sort Sam Vidil
collection DOAJ
description Abstract Background The concept of metabolic syndrome (MetS) was developed to identify individuals at higher risk of type 2 diabetes and cardiovascular disease, but its relevance for dementia remains unclear. We examined MetS in midlife for association with late-onset dementia, focusing on the thresholds of MetS components that carry risk for dementia. Methods MetS components (waist circumference, blood pressure, triglycerides, HDL-C, and fasting glucose) were measured on 6,137 white participants < 60 years from the Whitehall II (WII) cohort study. A changepoint method in time-to-event analyses was used to identify optimal thresholds, and those exhibiting better performance for dementia were retained to develop a revised MetS definition. Results were validated on 171,886 participants in the UK Biobank (UKB) study. Results Over a median follow-up of 22.6 years in WII and 13.8 years in UKB, 522 and 418 late-onset dementia cases were recorded, respectively. Optimized thresholds for triglycerides and fasting glucose performed better than original MetS thresholds in WII, and were used to develop a revised MetS definition. The MetS scale had a linear association with dementia, and 1-component increment (range 0 to 5) was associated with higher dementia risk using the revised MetS definition (HR, 95% CI: 1.11, 1.03–1.19) but not the original MetS definition (HR, 95% CI: 1.06, 0.98–1.14) in WII. In UKB, the revised MetS definition exhibited better performance for dementia risk than the original definition (p for HR comparison < 0.01). Conclusions MetS in midlife is potentially an important target for dementia prevention. However, the thresholds for triglycerides and glucose that carry risk need to be tailored specifically for dementia.
format Article
id doaj-art-1b7b2b767f9c4592b69f7a3b56c4cb8d
institution OA Journals
issn 1758-9193
language English
publishDate 2025-04-01
publisher BMC
record_format Article
series Alzheimer’s Research & Therapy
spelling doaj-art-1b7b2b767f9c4592b69f7a3b56c4cb8d2025-08-20T02:30:22ZengBMCAlzheimer’s Research & Therapy1758-91932025-04-0117111110.1186/s13195-025-01732-8Optimizing midlife metabolic syndrome thresholds for dementia: a prospective study of two UK population-based cohortsSam Vidil0Archana Singh-Manoux1Benjamin Landré2Aurore Fayosse3Séverine Sabia4Marcos D. Machado-Fragua5Epidemiology of Ageing and Neurodegenerative diseases (EpiAgeing), Université Paris Cité, Inserm U1153Epidemiology of Ageing and Neurodegenerative diseases (EpiAgeing), Université Paris Cité, Inserm U1153Epidemiology of Ageing and Neurodegenerative diseases (EpiAgeing), Université Paris Cité, Inserm U1153Epidemiology of Ageing and Neurodegenerative diseases (EpiAgeing), Université Paris Cité, Inserm U1153Epidemiology of Ageing and Neurodegenerative diseases (EpiAgeing), Université Paris Cité, Inserm U1153Epidemiology of Ageing and Neurodegenerative diseases (EpiAgeing), Université Paris Cité, Inserm U1153Abstract Background The concept of metabolic syndrome (MetS) was developed to identify individuals at higher risk of type 2 diabetes and cardiovascular disease, but its relevance for dementia remains unclear. We examined MetS in midlife for association with late-onset dementia, focusing on the thresholds of MetS components that carry risk for dementia. Methods MetS components (waist circumference, blood pressure, triglycerides, HDL-C, and fasting glucose) were measured on 6,137 white participants < 60 years from the Whitehall II (WII) cohort study. A changepoint method in time-to-event analyses was used to identify optimal thresholds, and those exhibiting better performance for dementia were retained to develop a revised MetS definition. Results were validated on 171,886 participants in the UK Biobank (UKB) study. Results Over a median follow-up of 22.6 years in WII and 13.8 years in UKB, 522 and 418 late-onset dementia cases were recorded, respectively. Optimized thresholds for triglycerides and fasting glucose performed better than original MetS thresholds in WII, and were used to develop a revised MetS definition. The MetS scale had a linear association with dementia, and 1-component increment (range 0 to 5) was associated with higher dementia risk using the revised MetS definition (HR, 95% CI: 1.11, 1.03–1.19) but not the original MetS definition (HR, 95% CI: 1.06, 0.98–1.14) in WII. In UKB, the revised MetS definition exhibited better performance for dementia risk than the original definition (p for HR comparison < 0.01). Conclusions MetS in midlife is potentially an important target for dementia prevention. However, the thresholds for triglycerides and glucose that carry risk need to be tailored specifically for dementia.https://doi.org/10.1186/s13195-025-01732-8Cardiometabolic risk factorsMetabolic syndromeOptimal thresholdsDementiaMidlife
spellingShingle Sam Vidil
Archana Singh-Manoux
Benjamin Landré
Aurore Fayosse
Séverine Sabia
Marcos D. Machado-Fragua
Optimizing midlife metabolic syndrome thresholds for dementia: a prospective study of two UK population-based cohorts
Alzheimer’s Research & Therapy
Cardiometabolic risk factors
Metabolic syndrome
Optimal thresholds
Dementia
Midlife
title Optimizing midlife metabolic syndrome thresholds for dementia: a prospective study of two UK population-based cohorts
title_full Optimizing midlife metabolic syndrome thresholds for dementia: a prospective study of two UK population-based cohorts
title_fullStr Optimizing midlife metabolic syndrome thresholds for dementia: a prospective study of two UK population-based cohorts
title_full_unstemmed Optimizing midlife metabolic syndrome thresholds for dementia: a prospective study of two UK population-based cohorts
title_short Optimizing midlife metabolic syndrome thresholds for dementia: a prospective study of two UK population-based cohorts
title_sort optimizing midlife metabolic syndrome thresholds for dementia a prospective study of two uk population based cohorts
topic Cardiometabolic risk factors
Metabolic syndrome
Optimal thresholds
Dementia
Midlife
url https://doi.org/10.1186/s13195-025-01732-8
work_keys_str_mv AT samvidil optimizingmidlifemetabolicsyndromethresholdsfordementiaaprospectivestudyoftwoukpopulationbasedcohorts
AT archanasinghmanoux optimizingmidlifemetabolicsyndromethresholdsfordementiaaprospectivestudyoftwoukpopulationbasedcohorts
AT benjaminlandre optimizingmidlifemetabolicsyndromethresholdsfordementiaaprospectivestudyoftwoukpopulationbasedcohorts
AT aurorefayosse optimizingmidlifemetabolicsyndromethresholdsfordementiaaprospectivestudyoftwoukpopulationbasedcohorts
AT severinesabia optimizingmidlifemetabolicsyndromethresholdsfordementiaaprospectivestudyoftwoukpopulationbasedcohorts
AT marcosdmachadofragua optimizingmidlifemetabolicsyndromethresholdsfordementiaaprospectivestudyoftwoukpopulationbasedcohorts