Metabolic syndrome linked to poorer cognition in schizophrenia

By Mark Cowen, Senior medwireNews Reporter

Schizophrenia patients with the metabolic syndrome have poorer cognitive functioning than those without, results from a US study show.

The researchers found that presence of the metabolic syndrome in patients with schizophrenia is associated with significantly greater impairments in three cognitive domains: processing speed, attention/vigilance, and problem solving/reasoning.

"Our findings may have important clinical implications," say Jean Pierre Lindenmayer (Manhattan Psychiatric Center, Ward's Island, New York) and team, who suggest that targeting individual components of the metabolic syndrome may help improve cognitive functioning in schizophrenia patients.

The findings come from a study of 159 patients with schizophrenia or schizoaffective disorder who were evaluated for the metabolic syndrome, and its individual components, using the National Cholesterol Education Program - Adult Treatment Panel (NCEP-ATP)-III criteria.

The participants also completed a battery of neuropsychologic and neurocognitive tests, including the Mini-Mental State Examination (MMSE).

Overall, 43.34% of the participants met NCEP-ATP-III criteria for the metabolic syndrome. This is in line with previous studies on the prevalence of the condition among patients with schizophrenia, and much higher than the age-adjusted prevalence of the metabolic syndrome in the US population (23.7%), the researchers note.

They found that patients with the metabolic syndrome had significantly poorer MMSE scores than those without for processing speed (3.78 vs 5.00), attention/vigilance (4.00 vs 5.77), and problem solving/reasoning (3.00 vs 4.39).

Regarding individual metabolic syndrome components, waist circumference and triglycerides were negatively associated with attention/vigilance scores, while high-density lipoprotein cholesterol was positively associated with scores in this cognitive domain, after accounting for age, gender, and other variables.

Writing in Schizophrenia Research, Lindenmayer and team conclude: "Schizophrenia patients with [the metabolic syndrome] showed significant cognitive impairments in three key cognitive domains.

They add: "Early intervention and active treatment of metabolic abnormalities based on a collaborative psychiatric-medical model may offer therefore important cognitive benefits for patients with chronic schizophrenia."

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