Plasma C Peptide Level and Cognitive Function Among Older Women Without Diabetes Mellitus

Okereke, Olivia I.; Hankinson, Susan E.; Hu, Frank B.; Grodstein, Francine

doi:10.1001/archinte.165.14.1651

Cited by 51 publications

(41 citation statements)

References 42 publications

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“…The strengths of this study include its large, population-based, multiethnic, longitudinal nature with repeat cognitive testing and its younger subject age than studies that have previously investigated longitudinal associations between hyperinsulinemia and dementia (14,15). Additional strengths are the use of two measures of insulin resistance, which we explored at both empirical and clinical cutoff levels.…”

Section: Methodsmentioning

confidence: 99%

“…Use of the ARIC cohort allowed for examination of the relationship between insulin and cognitive function in both men and women and allowed for assessment of potentially preclinical cognitive decline, unlike the study by Okereke et al (15), which included only older women in the Nurses' Health Study, and Peila et al (14), which included only elderly Japanese-American men. A limitation of this study is that we were unable to directly link time to development of decline; instead, we were limited to using a 6-year time frame.…”

Section: Methodsmentioning

confidence: 99%

“…Previous studies have produced conflicting evidence linking diabetes, glucose intolerance, and hyperinsulinemia to cognitive decline and Alzheimer's dementia (7). Previous epidemiologic studies relate hyperinsulinemia or type 2 diabetes to Alzheimer's dementia cross-sectionally in older adults (8 -12), whereas only a few studies have evaluated the longitudinal association between hyperinsulinemia and Alzheimer's dementia (13)(14)(15). None of these studies investigated an association between hyperinsulinemia and cognitive decline in middle-aged adults.…”

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confidence: 99%

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Hyperinsulinemia and Cognitive Decline in a Middle-Aged Cohort

2006

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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 middleaged 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. Diabetes Care 29:2688 -2693, 2006D etermining modifiable risks factors for cognitive decline and dementia is a public health priority as we seek to prevent dementia, which affects at least 4 million individuals in the U.S. (1). Current therapies, such as cholinesterase inhibitors, may slow cognitive decline in some patients, although the absolute changes in disease trajectory are modest (2-4). Type 2 diabetes and related disorders such as hyperinsulinemia increase with aging and are increasing in the U.S. population (5,6). Previous studies have produced conflicting evidence linking diabetes, glucose intolerance, and hyperinsulinemia to cognitive decline and Alzheimer's dementia (7). Previous epidemiologic studies relate hyperinsulinemia or type 2 diabetes to Alzheimer's dementia cross-sectionally in older adults (8 -12), whereas only a few studies have evaluated the longitudinal association between hyperinsulinemia and Alzheimer's dementia (13-15). None of these studies investigated an association between hyperinsulinemia and cognitive decline in middle-aged adults.Insulin resistance is known to be associated with the development of agerelated diseases including hypertension, coronary heart disease, stroke, cancer, and type 2 diabetes (16). People with insulin resistance are at an approximately fivefold risk for diabetes, but this...

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Hyperinsulinemia and Cognitive Decline in a Middle-Aged Cohort

2006

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“…Nevertheless, as the table 4 shows, the increase of the insulin basis dose taken by the patients, is connected with the reduction of appropriate abstract thinking, the speed and the efficiency of psycho-motor coordination, visual-spatial and verbal operating memory and executive functions, short-term auditory memory, visual memory, the effectiveness of learning and the selectivity of attention processes. As far as Okereke et al concerned [38], to high level of insulin can have a negative correlation with the proficiency of cognitive functions, even in a group of non-diabetic. Too high concentration of insulin in blood serum decreases the sensibility and density of insulin receptors on the cells' surface which has a negative impact on insulin action [39].…”

Section: Tmr -Raven's Matrix Test Tmt -Trail Making Testmentioning

confidence: 94%

Cognitive functions and clinical features among diabetic patients in Polish population

et al. 2009

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AbstractDiabetes is a chronic metabolic disease which can lead to numerous complications. One of these disturbances is cognitive function impairment. A group of 62 patients with type 1 and type 2 diabetes. There is a correlation between certain clinical features among diabetic patients and cognitive functions. Negative influence on cognitive functions have a higher level of total cholesterol, a higher level of LDL cholesterol, a lower level of HDL cholesterol concentration in the blood, a higher level of glucose after meals, a higher level of basic insulin dose and insulin dose taken just before the examination, longer duration of the diabetes and a lot of hypoglycemic episodes. There is no influence on cognitive functions from glucose levels before meals, the type of the insulin therapy, or the number of hyperglycemic episodes and value rate of hemoglobin HbA1C.

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“…Okereke et al had previously examined cognitive function in older women without diabetes (8) and in this special issue extend their study to older men without diabetes (9). The investigation is a prospective cohort design using 367 men who provided blood samples in 1982.…”

mentioning

confidence: 93%

From Depression to Where Are My Keys: Unlocking the Behavioral Disorders of Old Age

Smith

2006

The American Journal of Geriatric Psychiatry

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Plasma C Peptide Level and Cognitive Function Among Older Women Without Diabetes Mellitus

Abstract: Higher insulin secretion may be related to worse cognition, even among those without diabetes.

Cited by 51 publications

References 42 publications

Hyperinsulinemia and Cognitive Decline in a Middle-Aged Cohort

Hyperinsulinemia and Cognitive Decline in a Middle-Aged Cohort

Cognitive functions and clinical features among diabetic patients in Polish population

From Depression to Where Are My Keys: Unlocking the Behavioral Disorders of Old Age

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