Metabolic Disorders Linked With Greater Cognitive Deficits in People With Schizophrenia

Metabolic syndrome, diabetes, and hypertension are linked with greater global cognitive impairment in people with schizophrenia, according to a systematic review and meta-analysis published online ahead of print in JAMA Psychiatry. 

“Results of this meta-analysis of the association between metabolic syndrome and its components, including diabetes, indicate that patients with schizophrenia with vs without comorbid metabolic syndrome, diabetes, or hypertension have more severe global cognitive deficits,” researchers wrote.

The systematic review and meta-analysis included 27 studies spanning a total 10,174 patients with schizophrenia.

Quiz: Psychosocial Interventions for Patients With Schizophrenia

Significantly greater global cognitive deficits were found in patients with schizophrenia who also had metabolic syndrome, compared with patients who did not have metabolic syndrome, according to 13 studies involving 2800 people. Additionally, global cognitive deficits were larger in patients who had diabetes than in patients who did not in 8 studies involving 2976 people, as well as in patients who had hypertension compared with those who did not in 5 studies involving 1899 people.

The meta-analysis also found greater global cognitive deficits in patients with obesity (8 studies involving 2779 patients with schizophrenia), patients who were overweight (8 studies involving 2825 patients), and patients with insulin resistance (1 study involving 193 patients). However, those findings did not reach statistical significance.

“In individuals with cardiovascular risk factors, cognitive impairment should be detected, and cardiovascular risk factors and cognition should be managed,” researchers advised. “Additionally, accumulation or worsening of cardiovascular risk factors should be prevented as much as possible, choosing psychotropic medications with low risk to worsen cardiovascular risk factors and cognition, and promoting healthy lifestyle behaviors.”

—Jolynn Tumolo

Reference 

Hagi K, Nosaka T, Dickinson D, et al. Association between cardiovascular risk factors and cognitive impairment in people with schizophrenia: a systematic review and meta-analysis. JAMA Psychiatry. 2021 March 3;[Epub ahead of print].