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Insulin resistance and cognitive test performance in elderly adults: National health and nutrition examination survey (NHANES).

Abstract：

OBJECTIVES:To examine the relationship between homeostatic model of insulin resistance (HOMA-IR) and cognitive test performance among population≥60years in a national database. HYPOTHESIS:Higher insulin resistance is associated with lower cognitive test performance score in the population≥60years. PARTICIPANTS:We analyzed data from the National Health and Nutrition Examination Survey (NHANES) 1999-2000 and 2001-2002. MEASUREMENTS:Cognitive test performance was measured by the Digit Symbol Substitution (DSS) exercise score. The main independent variable was the homeostasis model assessment of insulin resistance (HOMA-IR). We used bivariate analysis and generalized linear model adjusting for age, gender, race, education, body mass index, and systolic and diastolic blood pressures; total cholesterol, low density lipoprotein (LDL), high density lipoprotein (HDL) and triglyceride levels; and physical activity, diabetes mellitus, stroke, and congestive heart failure. STATA 14 was used to analyze the data taking into consideration the design, strata and weight. RESULTS:Of the 1028 participants, 44% were male and 85% were white. The mean age was 70.0±0.28 (SE) years. Their average HOMA-IR was 3.6±0.14 and they had a mean of 49.2±0.8 correct DSS score in the cognitive test. Adjusting for the confounding variables, HOMA-IR was associated with decline in DSS score (B=-0.30, 95% confidence interval=-0.54 and -0.05, p=0.01). The model explained 44% of the variability of the DSS score (R2=0.44). Significant predictors of decline in DSS score were age, gender, race, and education (p=0.01). CONCLUSION:Insulin resistance as measured by HOMA-IR was independently associated with lower cognitive test performance score among elderly participants aged ≥60years. Longitudinal studies are needed to test the mechanism and the causal relationship.

journal_name

J Neurol Sci

journal_title

Journal of the neurological sciences

authors

Sherzai AZ,Shaheen M,Yu JJ,Talbot K,Sherzai D

doi

10.1016/j.jns.2017.11.031

subject

Has Abstract

pub_date

2018-05-15 00:00:00

pages

97-102

eissn

0022-510X

issn

1878-5883

pii

S0022-510X(17)34464-7

journal_volume

388

pub_type

杂志文章

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