An association study between epicardial fat thickness and cognitive impairment in the elderly

Gianluigi Mazzoccoli, Mariangela Pia Dagostino, Manlio Vinciguerra, Filomena Ciccone, Giulia Paroni, Davide Seripa, Filomena Addante, Rosa Chiara Montella, Salvatore De Cosmo, Francesco Sera, Antonio Greco

Research output: Contribution to journalArticlepeer-review


The amount of fat surrounding the heart, called epicardial adipose tissue (EAT), is a marker of cardiometabolic risk and correlates with the quantity of visceral adipose tissue (VAT). The amount of VAT is associated with an increased risk of cardiovascular and cerebrovascular disease and with cognitive impairment. We aimed to evaluate the association between EAT thickness as a measure of VAT and cognitive function. In 71 elderly subjects (mean age 72.7 ± 7.1 yr) we measured EAT thickness through transthoracic echocardiography, assessed the metabolic profile through evaluation of biochemical parameters, and estimated the cognitive function via the Mini Mental State Examination (MMSE). We found that greater EAT thickness was associated with lower cognitive performance evaluated by MMSE (P <0.01) independently of the presence or absence of metabolic syndrome or obesity. Lower MMSE results were also associated with the presence of metabolic syndrome (P <0.01), elevated HOMA index (P <0.01), and high BMI values (P <0.01). The results of mediation analysis confirmed that the total effect of metabolic syndrome, HOMA, and BMI on MMSE is mainly explained by an indirect effect through EAT thickness. In conclusion, increased EAT thickness assessed by transthoracic echocardiography is associated with deficient results of psychometric tests assessing cognitive performance and may consistently foresee impairment of cognition in the elderly.

Original languageEnglish
Pages (from-to)H1269-H1276
JournalAmerican Journal of Physiology - Heart and Circulatory Physiology
Issue number9
Publication statusPublished - Nov 1 2014


  • Cardiometabolic risk
  • Cognitive impairment
  • Epicardial fat
  • MMSE

ASJC Scopus subject areas

  • Physiology
  • Physiology (medical)
  • Cardiology and Cardiovascular Medicine
  • Medicine(all)


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