Midlife Metabolic Profile and the Risk of Late-Life Cognitive Decline

Abstract

Abstract. Among metabolic syndrome components, the effects of higher plasma glucose levels on cognitive decline (CD) have been considered in few studies. We evaluated the associations among midlife glycemia, total cholesterol, high-density lipoprotein cholesterol, triglycerides, midlife insulin resistance [homeostasis model assessment for insulin resistance (HOMAindex)], and CD in the older subjects of the population-based MICOL Study (Castellana Grotte, Italy) at baseline (M1) and at follow-ups seven (M2) and twenty years later (M3). At M1, a dementia risk score and a composite cardiovascular risk score for dementia were calculated. For 797 subjects out of 833, we obtained a Mini-Mental State Examination (MMSE) score at M3, subdividing these subjects in three cognitive functioning subgroups: normal cognition, mild CD, and moderate-severe CD. Mean fasting glycemia at baseline was significantly higher in moderate-severe CD subgroup (114.6 ± 71.4 mg/dl) than in the normal cognition subgroup (101.2 ± 20.6). Adjusting for gender, age, and other metabolic components, higher fasting glycemia values both at M1 [odds ratio (OR) = 1.31; 95% confidence interval (CI): 1.08-1.59] and M2 (OR = 1.26; 95% CI: 1.01-1.57) were associated with an increased risk of moderate-severe CD. Mean HOMA index value was significantly higher in the moderate-severe CD subgroup (5.7 ± 9.4) compared to the normal cognition subgroup (2.9 ± 1.4) at M1. The dementia risk probability (MMSE < 24) increased moving through higher categories of the dementia risk score and decreased as long as the cardiovascular score increased. The present findings highlighted the indication to control blood glucose levels, regardless of a diagnosis of diabetes mellitus, as early as midlife for prevention of late-life dementia.

Follow-up of blood glucose distribution characteristics in a health examination population in Chengdu from 2010 to 2016

“…Mean homeostasis model assessment for insulin resistance (HOMA) index value was significantly higher in the moderate-severe CD subgroup compared to the normal cognition subgroup at baseline, highlighting the indication to control blood glucose levels, regardless of a diagnosis of diabetes mellitus, as early as midlife for prevention of late-life dementia. [ 8 ] Since some of the complications of diabetes correlate with severe mortality, it is accepted that early detection, diagnosis of diabetes and take action to prevent diabetes development or its complications is of importance. Regular health examination is an important way for early detection of diabetes and glucose intolerance.…”

No Effects of Black Tea on Cognitive Decline Among Older US Men: A Prospective Cohort Study

“…In the Chinese and Japanese culture, tea is traditionally consumed without sugar, milk and creamer, while the practice of using additives is common in Western populations. A previous study showed that blood glucose concentration, regardless of a diagnosis of diabetes mellitus, is a risk factor of late life cognitive decline [14]. …”

Metabolic Syndrome and Its Biomarkers in the Development and Progression of Alzheimer’s Disease and Other Dementias

“…Rosanna Tortelli et al examined the cognitive status of Italian population compared with their metabolic status in a study conducted in 1985. They found that those with insulin resistance or diabetes in 1985 had an increased risk of suffering dementia 20 years later [67]. Chronic metabolic alterations have cardiovascular and believed to be cerebrovascular effects.…”