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Insulin resistance, fasting insulin predict cognitive decline
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In adults in Finland, higher fasting insulin resistance and serum fasting insulin level independently predicted poorer verbal fluency and a greater decline in verbal fluency during 11 years compared adults with normal insulin response, study data show.
Laura L. Ekblad , MD, of the Turku PET Centre at the University of Turku in Finland, and colleagues evaluated data from the Finnish nationwide, population-based Health 2000 Health Examination Survey and its 11-year follow-up, the Health 2011 survey of 3,695 adults (mean age at baseline, 49.3 years; 55.5% women) to determine whether insulin resistance independently predicts cognitive decline.
Insulin resistance was assessed using homeostasis model of assessment of insulin resistance (HOMA-IR). Fasting insulin, glucose, HbA1c and high-sensitivity C-reactive protein (hsCRP) levels were also measured as predictors of cognitive decline.
A lower verbal frequency score was associated with higher HOMA-IR (P < .0001), glucose (P = .02) and insulin (P < .0001) in the linear regression analyses adjusted for age, sex and education. Verbal fluency scores 11 years later were not associated with HbA1c or hsCRP levels. Word-list learning and word-list delayed recall tests were not predicted by HOMA-IR, fasting insulin, glucose, HbA1c or hsCRP. From 2000 to 2011, higher baseline HOMA-IR (P = .004) and insulin (P = .005) levels were associated with a greater decline in verbal fluency.
Decline in verbal fluency was predicted by HOMA-IR and insulin levels (P = .004 for both).
“We show that [insulin resistance] is an independent risk factor for cognitive decline and, more specifically, a decline in verbal fluency,” the researchers wrote. “Although the differences between the tertiles of [insulin resistance] in verbal fluency performance are small, and not of clinical significance at the individual level, these subtle changes in cognition associated with [insulin resistance] could lower the threshold for more severe changes in cognition over time. Longitudinal studies involving more detailed neuropsychological assessment and brain anatomical and functional imaging are needed to explore the difference cognitive domains and the neuroanatomical and neuropathologic changes associated with [insulin resistance]. Targeting therapeutic strategies, such as lifestyle interventions, at people with [insulin resistance] in midlife could potentially reduce the incidence of cognitive decline later in life.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
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