期刊
AMERICAN JOURNAL OF MEDICINE
卷 132, 期 3, 页码 367-373出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.amjmed.2018.11.013
关键词
Cognition; Dementia; Insulin; Insulin resistance
资金
- Academy of Finland [278457, 287490, 294061]
- Alzheimerfonden (Sweden)
- Center for Innovative Medicine (CIMED) at Karolinska Institutet South Campus
- Knut and Alice Wallenberg Foundation (Sweden)
- Stiftelsen Stockholms Sjukhem (Sweden)
- Konung Gustaf V:s och Drottning Victorias Frimurarstiftelse (Sweden)
- Fredrik O Ingrid Thurings Stiftelse
- Capio Forskningsstiftelse
- ALF grants [20130507, 20150589]
- Academy of Finland (AKA) [278457, 294061, 278457] Funding Source: Academy of Finland (AKA)
PURPOSE: The aim of this study was to examine the association of serum glucose, insulin, and insulin resistance with cognitive functioning 7 years later in a longitudinal population-based study of Finnish older adults. METHODS: Serum glucose and insulin were measured at baseline in 269 dementia-free individuals aged 65-79 years, from the Cardiovascular Risk Factors, Aging, and Dementia (CAIDE) study. Insulin resistance was estimated with the homeostasis model assessment (HOMA-IR). Participants were reexamined 7 years later, and global cognition, episodic memory, executive functioning, verbal expression, and psychomotor speed were assessed, both at baseline and at follow-up. Multiple linear regression was used to investigate the associations with cognitive performance at follow-up, after adjusting for several potential confounders, including common vascular risk factors. RESULTS: In the multivariable-adjusted linear regression models, no associations of insulin resistance with cognitive functioning were observed. After excluding 19 incident dementia cases, higher baseline HOMA-IR values were related to worse performance in global cognition (beta [standard error (SE)] -.050 [0.02]; P =.043) and psychomotor speed (beta [SE] -.064 [. 03]; P = [.043]) 7 years later. Raised serum insulin levels were associated with lower scores on global cognition (b [SE] -.054 [.03]; P =.045) and tended to relate to poorer performance in psychomotor speed (beta [SE] -.061 [.03]; P =.070). CONCLUSIONS: Serum insulin and insulin resistance may be independent predictors of cognitive performance 7 years later in elderly individuals without dementia. Randomized controlled trials are needed to determine this issue. (C) 2018 Elsevier Inc. All rights reserved.
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