Associations of insulin resistance with cognition in individuals without diagnosed diabetes: Results from the Hispanic Community Health Study/Study of Latinos.

Abstract

AIMS:

Insulin resistance (IR) adversely impacts memory and executive functioning in non-Hispanic whites without diabetes. Less is known in Hispanics/Latinos, despite the fact that Hispanics/Latinos have higher rates of insulin resistance than non-Hispanic whites. We investigated the association between IR and cognition and its variation by age.

METHODS:

Data from 5987 participants 45-74 years old without diabetes from the Hispanic Community Health Study/Study of Latinos. IR was considered continuously using homeostasis model assessment for insulin resistance (HOMA-IR) and also dichotomized based on clinically relevant thresholds for hyperinsulinemia (fasting insulin > 84.73 pmol/L or HOMA-IR > 2.6) and sample-based norms (75th percentile of fasting insulin or HOMA-IR). Cognitive testing included the Brief Spanish English Verbal Learning Test (B-SEVLT), Verbal Fluency, and Digit Symbol Substitution.

RESULTS:

There was 90% overlap in participant categorization comparing clinically relevant and sample-based thresholds. In separate fully-adjusted linear regression models, age modified the association between HOMA-IR and Digit Symbol Substitution (p = 0.02); advancing age combined with higher HOMA-IR levels resulted in higher scores. Age also modified the association between clinically relevant hyperinsulinemia and B-SEVLT recall (p = 0.03); with increasing age came worse performance for individuals with hyperinsulinemia.

CONCLUSION:

The relationship of IR with cognition in Hispanics/Latinos without diabetes may reflect an age- and test-dependent state.

• Authors: Mitzi M Gonzales, Ramon A Durazo-Arvizu, Shruti Sachdeva, Terry G Unterman, Matthew J O'Brien, Linda C Gallo, Gregory A Talavera, Robert C Kaplan, Jianwen Cai, Neil Schneiderman, Rebeca A Espinoza Giacinto, Hector M González, Martha L Daviglus, Melissa Lamar
• Journal: Diabetes research and clinical practice (Diabetes Res Clin Pract) Vol. 150 Pg. 38-47 (Apr 2019) ISSN: 1872-8227 [Electronic] Ireland
• PMID: 30779969 (Publication Type: Journal Article)
• Copyright: Copyright © 2019 Elsevier B.V. All rights reserved.

Topics

• Adolescent
• Adult
• Aged
• Cognition Disorders (etiology, psychology)
• Community Health Services
• Diabetes Mellitus
• Female
• Hispanic or Latino (psychology)
• Humans
• Hyperinsulinism (complications)
• Insulin Resistance
• Male
• Middle Aged
• Prognosis
• Prospective Studies
• Young Adult