Síndrome metabólico en la enfermedad de Alzheimer: influencias clínicas y evolutivas

INTRODUCTION: Metabolic syndrome (MS) results in an increased risk of developing Alzheimer's disease (AD), but its implications when the disease is already well established remain unknown. AIM. To assess the influence of MS in the clinical manifestations and its effect on mortality among AD patients treated with anti-Alzheimer drugs. PATIENTS AND METHODS: We conducted a retrospective cohort study with 751 outpatients from a dementia clinic who were diagnosed with AD and who had been prescribed cholinesterase inhibitors and/or memantine. Data was collected in a standardised manner from the patients' medical records. RESULTS: The mean follow-up time was 27.52 +/- 12.15 months. Frequency of MS was 24.6% (n = 185). The mortality rate throughout the period of study was 14.0% (n = 105). Patients with MS are younger and present lower degrees of cognitive and functional impairment, with greater organic comorbidity at the expense of heart diseases. They take more medicines and are given fewer atypical antipsychotics at the expense of olanzapine, above all. When age, sex, the basic activities of daily living and conduct disorders subscales from the Blessed scale (BDRS), the Cumulative Illness Rating Scale (CIRS) for heart disease and the Folstein Mini-Mental State Examination (MMSE) were included in the model, MS did not increase the risk of mortality. CONCLUSIONS: Patients with MS are diagnosed with AD at an earlier age despite having a lower degree of cognitive and functional impairment. MS does not give rise to an increase in the mortality rate of patients with AD.