title: Impaired glucose metabolism slows executive function independent of cerebral ischemic lesions in Japanese elderly: the Takahata study.
abstract: OBJECTIVE
  Age is known to influence the risk of both cerebral ischemic lesions and impaired cognitive function. Diabetes mellitus (DM) can also be associated with cognitive impairment. However, there has been no study of neuropsychological performance in association with glucose metabolism status and cerebral ischemic lesions in same-aged, community-dwelling elderly persons. The present study was performed to clarify which cognitive domains are associated with impaired glucose metabolism/DM and whether the association is independent of cerebral ischemic lesions.
  
  
  METHODS
  A total of 172 residents in Takahata, Japan, all of whom were 78 years old, were evaluated in multiple domains through neuropsychological tests and brain MR images, as well as a medical check-up including tests for glucose metabolism status and conventional vascular risk factors. Glucose metabolism status was determined by analysis of HbA1c level.
  
  
  RESULTS
  In multiple regression analyses, performance on a verbal fluency (VF) test and the Trail Making Test-Part B, both of which represent executive function, was associated with HbA1c level, even after adjustment for sex, education, cerebral ischemic lesions, and conventional vascular risk factors. The subjects with DM also showed lower VF scores than did those without DM.
  
  
  CONCLUSIONS
  The results of the present study demonstrate that impaired glucose metabolism, independent of the conventional vascular risk factors and cerebral ischemic lesions, may be associated with a decline in executive function in community-dwelling elderly.
authors.affiliation: Department of Neurology, Hematology, Metabolism, Endocrinology, and Diabetology (DNHMED), Yamagata University Faculty of Medicine, Japan.
authors.forename: Yoshimi
authors.initials: Y
authors.lastname: Takahashi
authors.forename: Chifumi
authors.initials: C
authors.lastname: Iseki
authors.forename: Manabu
authors.initials: M
authors.lastname: Wada
authors.forename: Tadasuke
authors.initials: T
authors.lastname: Momma
authors.forename: Masao
authors.initials: M
authors.lastname: Ueki
authors.forename: Toru
authors.initials: T
authors.lastname: Kawanami
authors.forename: Makoto
authors.initials: M
authors.lastname: Daimon
authors.forename: Kyoko
authors.initials: K
authors.lastname: Suzuki
authors.forename: Gen
authors.initials: G
authors.lastname: Tamiya
authors.forename: Takeo
authors.initials: T
authors.lastname: Kato
mesh_terms: D000368:Aged; D044466:Asian People / Q000208:ethnology / Q000523:psychology*; D001786:Blood Glucose / Q000378:metabolism*; D002545:Brain Ischemia / Q000378:metabolism* / Q000523:psychology*; D056344:Executive Function / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests
chemical_list: D001786:Blood Glucose