title: Insulin is differentially related to cognitive decline and atrophy in Alzheimer's disease and aging.
abstract: We assessed the relationship of insulin resistance with cognitive decline and brain atrophy over two years in early Alzheimer's disease (AD, n=48) and nondemented controls (n=61). Intravenous glucose tolerance tests were conducted at baseline to determine insulin area-under-the-curve (AUC). A standard battery of cognitive tasks and MRI were conducted at baseline and 2-year follow-up. In nondemented controls, higher baseline insulin AUC was associated with 2-year decline in global cognitive performance (beta=-0.36, p=0.005). In early AD, however, higher insulin AUC was associated with less decline in global cognitive performance (beta=0.26, p=0.06), slower global brain atrophy (beta=0.40, p=0.01) and less regional atrophy in the bilateral hippocampi and cingulate cortices. While insulin resistance is associated with cognitive decline in nondemented aging, higher peripheral insulin may have AD-specific benefits or insulin signaling may be affected by systemic physiologic changes associated with AD. This article is part of a Special Issue entitled: Imaging Brain Aging and Neurodegenerative disease.
authors: Department of Neurology, 3599 Rainbow Blvd, University of Kansas School of Medicine Kansas City, KS 66160, USA. jburns2@kumc.edu
authors: Jeffrey M
authors: JM
authors: Burns
authors: Robyn A
authors: RA
authors: Honea
authors: Eric D
authors: ED
authors: Vidoni
authors: Lewis J
authors: LJ
authors: Hutfles
authors: William M
authors: WM
authors: Brooks
authors: Russell H
authors: RH
authors: Swerdlow
mesh_terms: D000368:Aged; D000375:Aging / Q000378:metabolism* / Q000473:pathology; D000544:Alzheimer Disease / Q000378:metabolism* / Q000473:pathology; D019540:Area Under Curve; D001284:Atrophy / Q000378:metabolism* / Q000473:pathology; D003072:Cognition Disorders / Q000378:metabolism* / Q000473:pathology; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005951:Glucose Tolerance Test / Q000379:methods; D006179:Gyrus Cinguli / Q000378:metabolism / Q000473:pathology; D006624:Hippocampus / Q000378:metabolism / Q000473:pathology; D006801:Humans; D007328:Insulin / Q000378:metabolism*; D007333:Insulin Resistance; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D059906:Neuroimaging / Q000379:methods
chemical_list: D007328:Insulin