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Late life insulin resistance and Alzheimer's disease and dementia: The Kuakini Honolulu heart program

      Highlights

      • Insulin signaling in the brain is an emerging theory behind Alzheimer's disease.
      • Insulin resistance is associated with adverse metabolic and cognitive effects at midlife.
      • Elderly subjects, older than 74 years of age, saw decreased odds of Alzheimer's disease if they were insulin resistant.
      • The aging process creates inverse relationships between insulin resistance and cognitive function.

      Abstract

      Introduction

      Recent findings outline negative effects of brain insulin signaling on memory due to hyperinsulinemia. We investigated the association between insulin resistance (IR) with AD and dementia.

      Methods

      Later life Japanese men (N = 1544, mean age = 79.9 years) with normal cognitive function were followed from exam 4 to 5 of the Kuakini Honolulu Asia Aging Study. Subjects underwent physical exams, blood draws, and neuropsychological testing. IR status was determined at exam 4 using the McAuley and HOMA indices. Subjects with prevalent diabetes and dementia were excluded. Incident dementia and AD cases were determined at exam 5.

      Results

      IR was associated with decreased odds of AD and dementia using both IR indices. Carriers of the APOE ε4 allele had 15% increased odds of AD and dementia.

      Discussion

      Our findings provide insight regarding possible inverse relationship between IR and AD in elderly Japanese men, and support biologic studies showing short term hyperinsulinemia improves memory and cognitive function.

      Keywords

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