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Dementia is among the most frequent causes of disability in the elderly. Up today, there are no effective therapies that allow to modify the disease course. Great efforts have been made in studying biological correlates of dementia. A growing body of evidence is reporting that classical cardiovascular risk factors are potent predictors of several forms of dementia. Although hypertension has been the most studied in relation to cognitive function, it is yet difficult to pool results and draw strong inferences, due to relevant methodological differences across studies. The association between blood pressure and dementia seems to be complex and far from being unidirectional. Both high and low blood pressure levels have been reported to be associated with impairment in cognitive function in older subjects. Age-related changes in both blood pressure levels and cognitive function, as well as vascular brain damage and systemic arterial aging, may exert a confounding role. Future longitudinal studies are deemed necessary in order to obtain consistent results. In general, the hypothesis of dementia prevention by risk factor control at a population level needs to be established.

Introduction: NAFLD (non-alcoholic fatty liver disease) reaches an high prevalence in the general population, and it is closely related to metabolic syndrome (MetS). The entity of metabolic abnormalities and the chronic inflammation seem to play a main role in the development of liver fibrosis. The aim of our study is to determine whether subjects with NAFLD and MetS have higher liver fibrosis degree when compared with NAFLD subjects without MetS, and to investigate the relations between fibrosis, MetS and its single components and inflammation., Materials and Methods: We considered 24 patients with NAFLD. Those who had viral- and alcohol- related liver disease were excluded. MetS was diagnosed according to NCEP ATP III criteria; inflammatory status was determined through C-reactive protein (PCR) assay. The peripheral insulin-resistance was assessed by calculating HOMA ir. Liver fibrosis was measured by transient elastography (Fibroscan®)., Results: Subjects with MetS had higher HOMA ir, PCR and Fibroscan® score (log value: 0.92±0.24 KPa vs 0.73±0.2 KPa; p=0.047). The linear correlation analysis showed that Fibroscan® score was related to MetS, number of MetS components, waist circumference, HOMA ir and PCR. However the multivariate regression analysis showed that only HOMA ir (B=0.077; 95%CI: -0.002- 0.157; p=0.05) and PCR (B=0.152; 95% CI: 0.006 - 0.299; p=0.006) were independent predictors of higher Fibroscan® score., Conclusion: MetS is associated to higher liver fibrosis degree in subjects with NAFLD. The insulin-resistance and inflammation seem to be the main determinants.