Supplementary Material

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Background: Cognitive screening by pharmacists may help to identify seniors with metabolic syndrome (MetS)-related cognitive impairment. We aimed to evaluate the implementation of an easy-to-use cognitive screening into the pharmaceutical care of seniors and to test whether cognitive decline is associated with suspected MetS (sMetS).

Methods: Questionnaires were completed by 323 randomly selected elderly patients receiving pharmaceutical care in community pharmacies or in senior care centres in Slovakia. The presence of sMetS was estimated according to criteria of the International Diabetes Federation. Cognitive performance was evaluated by the Montreal Cognitive Assessment (MoCA) test and its short form (s-MoCA). In these tests, the cut-offs for impaired cognitive status were ≤ 24, and ≤ 12, respectively.

Results: 56% of participants scored below the screening cut-off MoCA threshold. Cognitive impairment was significantly more frequent in sMetS+ subjects (71%) vs. sMetS- (52%; p < 0.05). MoCA scores were significantly lower in sMetS+ (mean ± SD = 20.0 ± 5.9 points) vs. sMetS- (22.2 ± 5.4 points; p < 0.05). sMetS components type 2 diabetes mellitus, hypertension and obesity, but not dyslipidaemia, had an influence on lower cognitive performance.

Conclusions: We unveiled a significant relationship of cognitive dysfunction to sMetS in elderly patients. A quick and simple cognitive assessment could be a helpful extension of pharmaceutical care.