Effect of age and glucoregulation on cognitive performance.

Type 2 diabetes has been associated with a number of physiological consequences including neuropathy, retinopathy, and incidence of vascular disease. Less is known about the effect on cognition of prediabetes, a period when glucose regulation is abnormal. It is not clear which aspect of impaired glucoregulation is most predictive of cognitive deterioration. In the present experiment, we measured cognitive function in 93 healthy male and female nondiabetic older participants who ranged in age from 55 to 88 years. Various biological measures were obtained including a glucose tolerance test during which glucose and insulin were measured. Participants were evaluated twice, once after drinking a saccharin solution and on another occasion after drinking a glucose solution (50 g). The analysis of the correlations between the biological measures and the results of the cognitive tasks revealed that evoked glucose measures such as peak glucose and glucose at 1 hour were most often correlated with cognitive performance. We observed that progressively worse glucose regulation predicted poorer performance on measures of working memory and executive function-that is, on the Arithmetic, Digit Span Backward, Letter-Number Sequencing, Spatial Span Forward, Spatial Span Backward (trend), and Modified Brown-Peterson tasks. Although, there was no significant facilitative effect of glucose on cognitive performance, it reduced the association between glucose regulation and cognition, apparently by slightly improving performance. These results suggest that cognitive functions may be impaired before glucoregulatory impairment reaches levels consistent with a type 2 diabetes diagnosis.