Age-related vascular alterations promote the pathogenesis of vascular cognitive impairment (VCI). Cardiovascular risk factors that accelerate vascular aging exacerbate VCI. Metabolic syndrome (MetS) constitutes a cluster of critical cardiovascular risk factors (abdominal obesity, hypertension, elevated triglycerides, elevated fasting glucose, reduced HDL cholesterol), which affects nearly 37% of the adult US population. The present study was designed to test the hypotheses that MetS exacerbates cognitive impairment and that arterial stiffening moderates the association between cognitive dysfunction and MetS in older adults. MetS was defined by the NCEP ATP III guidelines. Cognitive function (digit span and trail-making tests) and brachial-ankle pulse wave velocity (baPWV; a non-invasive clinical measurement of arterial stiffness) were assessed in older adults with MetS and age- and sex-matched controls. Multiple linear regression models were applied to test for the main effects of MetS, baPWV, and their interaction on cognitive performance. Fifty-three participants with MetS (age: 68 ± 8 years) and 39 age-matched individuals without MetS (age: 66 ± 9 years) were enrolled into the study. In adjusted multivariable regression analyses of the digit span backward length score, both MetS (ß = 1.97, p = 0.048) and MetS by baPWV interaction (ß = − 0.001, p = 0.026) were significant predictors. In participants with MetS, higher baPWV was associated with poorer performance on digit span backward length score, a test of working memory (R = − 0.44, p = 0.0012), but there was no association in those without MetS (R = 0.035, p = 0.83). MetS was negatively associated with performance on the digit span backward length score, baPWV was negatively associated with multiple neuropsychological outcomes, and baPWV moderated the association between digit span backward length score and MetS, as individuals with both MetS and higher baPWV had the most impaired cognitive function. Our findings add to the growing body of evidence that individuals with MetS and higher baPWV may be prone to VCI.

与年龄相关的血管改变促进血管性认知障碍（VCI）的发病机制。加速血管老化的心血管危险因素会加剧 VCI。代谢综合征 (MetS) 是一系列重要的心血管危险因素（腹部肥胖、高血压、甘油三酯升高、空腹血糖升高、高密度脂蛋白胆固醇降低），影响着近 37% 的美国成年人口。本研究旨在检验以下假设：MetS 会加剧认知障碍，而动脉硬化会缓和老年人认知功能障碍与 MetS 之间的关联。MetS 由 NCEP ATP III 指南定义。在患有 MetS 的老年人以及年龄和性别匹配的对照中评估了认知功能（数字跨度和轨迹测试）和臂踝脉搏波速度（baPWV；动脉僵硬度的非侵入性临床测量）。应用多元线性回归模型来测试 MetS、baPWV 的主要影响及其对认知表现的相互作用。53 名患有 MetS 的参与者（年龄：68 ± 8 岁）和 39 名年龄匹配的未患有 MetS 的个体（年龄：66 ± 9 岁）参加了该研究。在调整后的数字跨度向后长度评分的多变量回归分析中，MetS (ß = 1.97, p  = 0.048) 和 baPWV 交互作用的 MetS (ß = − 0.001, p  = 0.026) 都是显着的预测因子。在患有 MetS 的参与者中，较高的 baPWV 与数字跨度向后长度得分（工作记忆测试）的较差表现相关（R  = − 0.44，p  = 0.0012），但在没有 MetS 的参与者中没有关联（R  = 0.035，p  = 0.83）。MetS 与手指跨度向后长度得分的表现呈负相关，baPWV 与多种神经心理学结果呈负相关，baPWV 调节手指跨度向后长度得分与 MetS 之间的关联，因为同时具有 MetS 和较高 baPWV 的个体认知受损最严重功能。我们的研究结果进一步证明，患有 MetS 和较高 baPWV 的个体可能容易患 VCI。