title: The relationship between cognitive performance and insulin resistance in non-diabetic patients with mild cognitive impairment.
abstract: OBJECTIVE
  Insulin resistance (IR) is a distinct and early feature of type 2 diabetes mellitus and metabolic syndrome. IR is thought to play a vital role in cognitive impairment. We conducted this study to understand the early characteristics of cognitive dysfunctions attributable to IR.
  
  
  METHODS
  This study included 85 consecutive non-diabetic elderly participants with mild cognitive impairment (MCI). IR was estimated with the homeostasis model assessment of insulin resistance (HOMA-IR). Cognitive performances were analyzed as a function of scores on the HOMA-IR.
  
  
  RESULTS
  The group analysis those with and without IR did not show any differences in the cognitive performance although higher HOMA-IR was closely associated with lower performances in immediate recall on the Seoul Verbal Learning Test (SVLT-I) (r = -0.244, p = 0.026) and Controlled Oral Word Association Test (COWAT) (r = -0.270, p = 0.013). In subgroup analysis by APOE status, SVLT-delayed (p = 0.027) and COWAT (p = 0.016) scores were found to be significantly lower in the IR than the non-IR among those with APOE ε4 allele. In multiple regression analysis, impairment on the COWAT remained significantly correlated with scores on HOMA-IR (β = -0.271, t = -2.340, p = 0.022). However, IR status was identified to interact with APOE ε4 carriership toward poor performances in the COWAT (β = -0.335, t = -2.285, p = 0.026).
  
  
  CONCLUSIONS
  This study found a domain-specific impact of HOMA-IR scores on cognitive performances in non-diabetic patients with MCI. This association was profound only in APOE ε4carriers.
authors: Department of Neurology, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea.
authors: Tae-Eun
authors: TE
authors: Kim
authors: Dong Hyun
authors: DH
authors: Lee
authors: Yoon-Jeong
authors: YJ
authors: Kim
authors: Ji Oh
authors: JO
authors: Mok
authors: Chul-Hee
authors: CH
authors: Kim
authors: Jeong-Ho
authors: JH
authors: Park
authors: Tae-Kyeong
authors: TK
authors: Lee
authors: Kwangsun
authors: K
authors: Yoo
authors: Yong
authors: Y
authors: Jeong
authors: Yunhwan
authors: Y
authors: Lee
authors: Sun Ah
authors: SA
authors: Park
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D053327:Apolipoprotein E4 / Q000235:genetics; D003071:Cognition / Q000502:physiology*; D060825:Cognitive Dysfunction / Q000235:genetics / Q000503:physiopathology*; D005260:Female; D006706:Homeostasis; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D008954:Models, Biological; D009483:Neuropsychological Tests; D012044:Regression Analysis
chemical_list: D053327:Apolipoprotein E4
keywords: apolipoprotein E; insulin resistance; mild cognitive impairment