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Metabolic syndrome (MetS), a cluster of metabolic abnormalities, has been proposed as a modifiable risk factor for dementia, although existing evidence remains inconsistent. This review examined recent studies on the association between MetS and dementia risk in older adults. We searched PubMed for original studies published between January 1, 2014, and July 15, 2024, using the keywords \u201cmetabolic syndrome\u201d and \u201cdementia.\u201d Fourteen studies met the inclusion criteria: five retrospective cohort studies, two prospective cohort studies, four cross\u2010sectional studies, two bioinformatics studies, and one meta\u2010analysis. Overall, MetS was associated with adverse cognitive outcomes, with relatively more consistent evidence for vascular dementia and progression from mild cognitive impairment to dementia than for Alzheimer disease. Hypertension, abdominal obesity, and low high\u2010density lipoprotein cholesterol were associated with adverse cognitive outcomes in some studies, although component\u2010specific findings varied across studies. Temporal patterns of MetS also appeared to be relevant, with some studies reporting higher dementia risk in individuals with worsening or persistent metabolic burden, although findings after MetS resolution were not consistent. Several studies also reported deficits in executive, attention, and visuospatial function. Bioinformatics studies suggested possible genetic links, including overlap with apolipoprotein E\u2010related pathways, although evidence remains limited. MetS may represent a clinically relevant risk marker for adverse cognitive outcomes in older adults, although its association varies according to MetS definition, study population, and cognitive outcome. Further large\u2010scale studies are needed to clarify the underlying mechanisms and subtype\u2010specific associations.<\/jats:p>","DOI":"10.1002\/kjm2.70276","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T08:06:28Z","timestamp":1787126788000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Metabolic Syndrome and Dementia Risk in Older Adults: A Narrative Review"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5420-930X","authenticated-orcid":false,"given":"Hyojin","family":"Park","sequence":"first","affiliation":[{"name":"Department of Family Medicine Hallym University Kangnam Sacred Heart Hospital  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mallika","family":"Chuansangeam","sequence":"additional","affiliation":[{"name":"Division of Geriatric Medicine, Department of Internal Medicine, Faculty of Medicine Thammasat University  Pathum Thani Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1918-9021","authenticated-orcid":false,"given":"Yuan\u2010Han","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Neurology Kaohsiung Medical University Gangshan Hospital, Kaohsiung Medical University  Kaohsiung Taiwan"},{"name":"Neuroscience Research Center Kaohsiung Medical University  Kaohsiung Taiwan"},{"name":"School of Post\u2010Baccalaureate Medicine, College of Medicine, Kaohsiung Medical University  Kaohsiung Taiwan"},{"name":"Department of Neurology Kaohsiung Medical University Hospital, Kaohsiung Medical University  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"issue":"2","key":"e_1_2_9_2_1","doi-asserted-by":"crossref","first-page":"e105","DOI":"10.1016\/S2468-2667(21)00249-8","article-title":"Estimation of the Global Prevalence of Dementia in 2019 and Forecasted Prevalence in 2050: An Analysis for the Global Burden of Disease Study 2019","volume":"7","author":"GBD 2019 Dementia Forecasting Collaborators","year":"2022","journal-title":"Lancet Public Health"},{"issue":"10","key":"e_1_2_9_3_1","doi-asserted-by":"crossref","first-page":"2093","DOI":"10.1016\/j.jamda.2021.05.040","article-title":"Disease Burdens of Alzheimer's Disease, Vascular Dementia, and Mild Cognitive Impairment","volume":"22","author":"Moon W.","year":"2021","journal-title":"Journal of the American Medical Directors Association"},{"issue":"10","key":"e_1_2_9_4_1","doi-asserted-by":"crossref","first-page":"1556","DOI":"10.1001\/archneur.62.10.1556","article-title":"Obesity and Vascular Risk Factors at Midlife and the Risk of Dementia and Alzheimer Disease","volume":"62","author":"Kivipelto M.","year":"2005","journal-title":"Archives of Neurology"},{"key":"e_1_2_9_5_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.phanu.2023.100350","article-title":"Trends in Nutrition, Lifestyle, and Metabolic Disease in the United States From 1900 Onwards","volume":"25","author":"Wiegers C.","year":"2023","journal-title":"PharmaNutrition"},{"issue":"2","key":"e_1_2_9_6_1","doi-asserted-by":"crossref","first-page":"70","DOI":"10.51789\/cmsj.2024.4.e14","article-title":"Metabolic Syndrome Fact Sheet 2024: Executive Report","volume":"4","author":"Kim H.\u2010J.","year":"2024","journal-title":"CardioMetabolic Syndrome Journal"},{"key":"e_1_2_9_7_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.diabres.2022.109924","article-title":"Geographic Distribution of Metabolic Syndrome and Its Components in the General Adult Population: A Meta\u2010Analysis of Global Data From 28 Million Individuals","volume":"188","author":"Noubiap J. 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