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Hyperinsulinemia and cognitive decline in a middle-aged cohort.

TitleHyperinsulinemia and cognitive decline in a middle-aged cohort.
Publication TypeJournal Article
Year of Publication2006
AuthorsYoung SE, Mainous AG, Carnemolla M
JournalDiabetes Care
Volume29
Issue12
Pagination2688-93
Date Published2006 Dec
ISSN0149-5992
KeywordsCognition Disorders, Cohort Studies, Comorbidity, Educational Status, Fasting, Female, Humans, Hyperinsulinism, Insulin, Longitudinal Studies, Male, Marital Status, Middle Aged
Abstract

OBJECTIVE: Determining modifiable risks factors for cognitive decline and dementia are a public health priority as we seek to prevent dementia. Type 2 diabetes and related disorders such as hyperinsulinemia increase with aging and are increasing in the U.S. population. Our objective was to determine whether hyperinsulinemia is associated with cognitive decline among middle-aged adults without type 2 diabetes, dementia, or stroke in the Atherosclerosis Risk in Communities (ARIC) cohort.

RESEARCH DESIGN AND METHODS: Middle-aged adults (aged 45-64 years at baseline) in the ARIC cohort had fasting insulin and glucose assessed between 1987 and 1989. Subjects with dementia, type 2 diabetes, or stroke at baseline were excluded from analysis. Three tests of cognitive function available at baseline and 6 years later were delayed word recall (DWR), digit symbol subtest (DSS), and first letter word fluency (WF). Cross-sectional comparisons and linear regression models were computed for cognitive tests at baseline and change in cognitive test scores to determine whether cognitive function was associated with two measures of insulin resistance, fasting insulin and homeostasis model assessment (HOMA). Linear regression models controlled for age, sex, race, marital status, education level, smoking status, alcohol use, depression, hypertension, and hyperlipidemia.

RESULTS: In unadjusted and adjusted analyses, hyperinsulinemia based on fasting insulin and HOMA at baseline was associated with significantly lower baseline DWR, DSS, and WF scores and a greater decline over 6 years in DWR and WF.

CONCLUSIONS: Insulin resistance is a potentially modifiable midlife risk factor for cognitive decline and dementia.

DOI10.2337/dc06-0915
Alternate JournalDiabetes Care
PubMed ID17130206
Grant List1D12HP00023 / / PHS HHS / United States
1D14HP00161 / / PHS HHS / United States
1PS0AG021677 / AG / NIA NIH HHS / United States