Insulin resistance and executive dysfunction in older persons

被引:82
作者
Abbatecola, AM
Paolisso, G
Lamponi, M
Bandinelli, S
Lauretani, F
Launer, L
Ferrucci, L
机构
[1] Univ Naples 2, Dept Geriatr Med & Metab Dis, Naples, Italy
[2] INRCA Florence, Dept Geriatr, Lab Clin Epidemiol, Florence, Italy
[3] NIA, Lab Epidemiol Biometry & Demog, Bethesda, MD 20892 USA
[4] NIA, Longitudinal Studies Sect, Baltimore, MD 21224 USA
关键词
aging; executive dysfunction; insulin resistance; Trail Making Test; InCHIANTI;
D O I
10.1111/j.1532-5415.2004.52466.x
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Objectives: To evaluate the association between insulin resistance (IR) and executive dysfunction in a large, population-based study of older persons without diabetes mellitus (DM) or dementia. Design: Cross-sectional study. Setting: Outpatient clinic in Greve in Chianti and Bagno a Ripoli, Italy. Participants: A total of 597 subjects aged 65 to 93 without DM or dementia. Measurements: Anthropometric measurements; plasma fasting levels of glucose, insulin, cholesterol (total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol), and insulin-like growth factor-1 (IGF-1); homeostasis model assessment (HOMA) to estimate degree of IR; Trail Making Test (TMT) A; TMT-B; TMT-B minus TMT-A (DIFF B-A); and Mini-Mental State Examination (MMSE). Results: IR (HOMA) was associated with longer TMT-B (correlation coefficient (r)=0.11; P=.006) and DIFF B-A times (r=0.10; P=.022). Subjects in the upper tertile of IR were older and had longer TMT-B and DIFF B-A than participants in the lowest tertile. After adjusting for age, sex, and years of formal education, IR was significantly correlated with TMT-A, TMT-B, and DIFF B-A. After adjusting for age, sex, education, body mass index, waist:hip girth ratio, HDL-C, triglycerides, IGF-1, hypertension, drug intake, and physical activity, the results did not significantly change. After introducing MMSE score into the model, IR continued to be an independent determinant of TMT-A (beta=11.005; P=.021), TMT-B (beta=28.379; P<.001), and DIFF B-A (beta=17.374; P=.011). Conclusion: IR is independently associated with frontal cortex function evidenced by poor TMT times in older persons without DM or dementia.
引用
收藏
页码:1713 / 1718
页数:6
相关论文
共 31 条
[1]  
Alberti KGMM, 1998, DIABETIC MED, V15, P539, DOI 10.1002/(SICI)1096-9136(199807)15:7<539::AID-DIA668>3.0.CO
[2]  
2-S
[3]  
American Psychiatric Association, 1994, DIAGN STAT MAN MENT
[4]   Ageing and diabetes: implications for brain function [J].
Biessels, GJ ;
van der Heide, LP ;
Kamal, A ;
Bleys, RLAW ;
Gispen, WH .
EUROPEAN JOURNAL OF PHARMACOLOGY, 2002, 441 (1-2) :1-14
[5]   Homeostasis model assessment closely mirrors the glucose clamp technique in the assessment of insulin sensitivity - Studies in subjects with various degrees of glucose tolerance and insulin sensitivity [J].
Bonora, E ;
Saggiani, F ;
Targher, G ;
Zenere, MB ;
Alberiche, M ;
Monauni, T ;
Bonadonna, RC ;
Muggeo, M .
DIABETES CARE, 2000, 23 (01) :57-63
[6]   Cognitive tests that best discriminate between presymptomatic AD and those who remain nondemented [J].
Chen, P ;
Ratcliff, G ;
Belle, SH ;
Cauley, JA ;
DeKosky, ST ;
Ganguli, M .
NEUROLOGY, 2000, 55 (12) :1847-1853
[7]  
CRAFT S, 1993, BEHAV NEUROSCI, V107, P926
[8]  
de Groot JC, 2000, ANN NEUROL, V47, P145
[9]  
DESANTIS S, 1995, PSYCHIAT QUART, V4, P357
[10]   Insulin-degrading enzyme regulates the levels of insulin, amyloid β-protein, and the β-amyloid precursor protein intracellular domain in vivo [J].
Farris, W ;
Mansourian, S ;
Chang, Y ;
Lindsley, L ;
Eckman, EA ;
Frosch, MP ;
Eckman, CB ;
Tanzi, RE ;
Selkoe, DJ ;
Guénette, S .
PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA, 2003, 100 (07) :4162-4167