Serum Insulin and Cognitive Performance in Older Adults: A Longitudinal Study

Hooshmand, Babak; Rusanen, Minna; Ngandu, Tiia; Leiviskä, Jaana; Sindi, Shireen; Arnim, Christine A. F. Von; Falkai, Peter; Tuomilehto, Jaakko; Kivipelto, Miia

doi:10.1016/j.amjmed.2018.11.013

Cited by 20 publications

(14 citation statements)

References 41 publications

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“…In the past, the relationship between insulin resistance and dementia has been investigated; however, the HOMA-IR index has been mainly used in studies to determine the degree of IR; however, the HOMA-IR index values are cumbersome to collect and have low possibility of clinical application. Previous studies have reported that a higher risk of dementia was associated with increased insulin levels and HOMA-IR index [ 10 , 12 , 44 , 45 , 46 , 47 ]. In populations at high risk of cardiovascular disease, baseline HOMA-IR levels are associated with short-term cognitive deterioration [ 48 ].…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have linked type 2 diabetes, caused by insulin resistance, to a higher risk of Alzheimer’s disease (AD) [ 8 , 9 ]. Other studies have found that increased serum insulin levels and insulin resistance are directly related to cognitive impairment [ 10 , 11 , 12 ]. The effect of this central IR on the occurrence and development of cognitive impairment may be related to changes in hippocampal synaptic plasticity [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

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The Triglyceride-Glucose Index Is Associated with Longitudinal Cognitive Decline in a Middle-Aged to Elderly Population: A Cohort Study

Zhang

2022

JCM

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Background: To examine the effect of the triglyceride-glucose (TyG) index on longitudinal cognitive decline in a healthy middle-aged-to-elderly population. Methods: We conducted a population-based longitudinal study. A total of 1774 participants without cognitive impairment were enrolled in the 4-year follow-up. They were divided into four groups according to the quartile of the TyG index. Multivariable-adjusted Cox proportional hazard models were performed to examine the association between the TyG index and cognitive decline. Discrimination tests were used to evaluate the incremental predictive value of the TyG index beyond conventional risk factors. Results: During the follow-up, compared with those in the bottom quartile group, participants in the top TyG quartile group presented a 51% increase in the risk of cognitive decline (OR 1.51 (95% CI: 1.06–2.14)). As shown by discrimination tests, adding the TyG index into the conventional model resulted in a slight improvement in predicting the risk of cognitive decline (NRI 16.00% (p = 0.004)). Conclusion: This study demonstrated that increasing values of the TyG index were positively associated with the risk of cognitive decline. Monitoring the TyG index may help in the early identification of individuals at high risk of cognitive deterioration.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Triglyceride-Glucose Index Is Associated with Longitudinal Cognitive Decline in a Middle-Aged to Elderly Population: A Cohort Study

Zhang

2022

JCM

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“…In einer Querschnittstudie, die Parameter des Insulinstoffwechsels im Serum und der Zerebrospinalflüssigkeit von Gesunden mit jenen von Patienten mit MCI oder früher AD verglich, gingen sowohl frühe Stadien der AD als auch MCI mit peripherer und zentraler IR einher [5]. Eine Beobachtungsstudie an 250 gesunden finnischen Senioren (65 -79 Jahre) zeigte eine inverse Korrelation zwischen IR sowie Hyperinsulinämie und globalen kognitiven Fähigkeiten nach 7 Jahren Follow-Up [9]. Ältere Typ-2-Diabetiker zeigten im Lauf von 4,6 Jahren ein stärkeres Nachlassen ihres verbalen Gedächtnisses und der Sprachflüssigkeit als Nichtdiabetiker.…”

Section: Insulinresistenzunclassified

Demenz und metabolisch-vaskuläre Risikofaktoren: Möglichkeiten der Prävention

Gonder

Schacky²,

Worm

et al. 2019

Dtsch med Wochenschr

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ZusammenfassungDie Prävalenz der Demenz ist in den letzten Jahren gestiegen und nimmt mit dem Alter exponentiell zu. In Deutschland sind ca. 1,7 Mio. Menschen betroffen, die jährliche Neuerkrankungsrate wird auf 300 000 geschätzt. Der Begriff Demenz umfasst verschiedene Krankheitsformen mit unterschiedlichen Ätiologien. Dem demenziellen Syndrom des höheren Lebensalters liegen meist vaskuläre und metabolische Risikofaktoren zugrunde, die der klinischen Demenzmanifestation um Dekaden vorausgehen. Dies bietet ein enormes Zeitfenster für die Prävention, welche insbesondere vor dem Hintergrund weitgehend fehlender kurativer pharmakologischer Ansätze eine große Bedeutung erlangt. Lebensstilmaßnahmen, die eine hohe Nahrungsqualität und eine ausreichende Versorgung mit Omega-3-Fettsäuren, körperliche Aktivität und erholsamen Schlaf beinhalten, verbessern metabolische und vaskuläre Risikofaktoren und mindern das Demenzrisiko. Da multimodale Konzepte synergistisch wirken, versprechen sie den größten präventiven Nutzen.

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“…IR is a hallmark of metabolic syndrome and type 2 diabetes and is linked to the development of cardiovascular disease 4,5 . Previous research indicates that IR is closely associated with an increased risk of CSVD 6–9 and cognitive impairment 10–12 . However, the role of IR in VCI in CSVD patients has been understudied.…”

Section: Introductionmentioning

confidence: 99%

“…4,5 Previous research indicates that IR is closely associated with an increased risk of CSVD [6][7][8][9] and cognitive impairment. [10][11][12] However, the role of IR in VCI in CSVD patients has been understudied. Thus, the present study investigated the association between IR and VCI in CSVD patients.…”

Section: Introductionmentioning

confidence: 99%

Increased insulin resistance is associated with vascular cognitive impairment in Chinese patients with cerebral small vessel disease

Guo

Zhu

et al. 2021

Psychogeriatrics

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Background The aim of this study was to investigate the association between insulin resistance (IR) and vascular cognitive impairment (VCI) in patients with cerebral small vessel disease (CSVD). Methods A total of 275 CSVD patients were enrolled in this retrospective case–control study. The homeostatic model assessment of insulin resistance (HOMA‐IR) was used to measure the index of insulin resistance. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA). Spearman's correlation coefficient was used to evaluate the correlation between HOMA‐IR and MoCA score. The variance inflation factor (VIF) was used to detect collinearity between variables. Multivariate logistic regression analysis was employed to confirm whether HOMA‐IR is an independent risk factor for VCI in CVSD. Finally, receiver operating characteristic (ROC) curve analysis was conducted to assess the diagnostic value of HOMA‐IR in VCI. Results Of the 275 patients, 164 displayed VCI. VCI patients showed a significantly higher level of HOMA‐IR compared to non‐VCI patients (P < 0.001). HOMA‐IR was negatively correlated with the MoCA score (r = −0.593, P < 0.001). After adjusting for potential confounding variables, using HOMA‐IR quartile 1 (<1.11) as the reference, HOMA‐IR quartile 3 (1.71–2.50) and quartile 4 (≥2.50) were independently associated with the occurrence of VCI; for each one unit increase in the HOMA‐IR, the risk of VCI increased by 177.3% (odds ratio 2.773, 95% confidence interval: 1.050–7.324, P = 0.040) and 444.3% (odds ratio 5.443, 95% confidence interval: 2.109–14.050, P < 0.001), respectively. According to the ROC curve, the optimal cut‐off point of HOMA‐IR in predicting VCI was 1.55, and the area under the curve was 0.744, with a sensitivity of 71.3% and a specificity of 69.4%. Conclusion This study demonstrated that increased IR is significantly associated with VCI in CSVD patients.

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Serum Insulin and Cognitive Performance in Older Adults: A Longitudinal Study

Cited by 20 publications

References 41 publications

The Triglyceride-Glucose Index Is Associated with Longitudinal Cognitive Decline in a Middle-Aged to Elderly Population: A Cohort Study

The Triglyceride-Glucose Index Is Associated with Longitudinal Cognitive Decline in a Middle-Aged to Elderly Population: A Cohort Study

Demenz und metabolisch-vaskuläre Risikofaktoren: Möglichkeiten der Prävention

Increased insulin resistance is associated with vascular cognitive impairment in Chinese patients with cerebral small vessel disease

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