Mitzi M Gonzales1, Ramon A Durazo-Arvizu2, Shruti Sachdeva3, Terry G Unterman4, Matthew J O'Brien5, Linda C Gallo6, Gregory A Talavera7, Robert C Kaplan8, Jianwen Cai9, Neil Schneiderman10, Rebeca A Espinoza Giacinto11, Hector M González12, Martha L Daviglus13, Melissa Lamar14. 1. Department of Neurology, The University of Texas Health Science Center at San Antonio, San Antonio, TX, United States. 2. Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, United States; Department of Biostatistics, Loyola University, Chicago, IL, United States. 3. Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, United States. 4. Department of Medicine, University of Illinois at Chicago, Chicago, IL, United States. 5. Division of General Internal Medicine and Geriatrics, Northwestern University, Chicago, IL, United States. 6. Department of Psychology, San Diego State University, San Diego, CA, United States. 7. Division of Health Promotion and Behavioral Sciences, San Diego State University, San Diego, CA, United States. 8. Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States. 9. Department of Biostatistics, University of North Carolina, Chapel Hill, NC, United States. 10. Department of Psychology, University of Miami, Miami, FL, United States. 11. Department of Psychology, San Diego State University, San Diego, CA, United States; Division of Health Promotion and Behavioral Sciences, San Diego State University, San Diego, CA, United States. 12. Department of Neuroscience, Shiley-Marcos Alzheimer's Disease Research Center, University of California San Diego, San Diego, CA, United States. 13. Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, United States; Department of Medicine, University of Illinois at Chicago, Chicago, IL, United States. 14. Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, United States; Department of Medicine, University of Illinois at Chicago, Chicago, IL, United States; Rush Alzheimer's Disease Center and Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States. Electronic address: melissa_lamar@rush.edu.
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.
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.
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