title: Insulin resistance is an important risk factor for cognitive impairment in elderly patients with primary hypertension.
abstract: OBJECTIVE
  Insulin resistance plays a role in the development of dementia and hypertension. We investigated a possible relationship between cognitive impairment and insulin resistance in elderly Chinese patients with primary hypertension.
  
  
  METHODS
  One hundred and thirty-two hypertensive elderly patients (>60 years) were enrolled in this study, and assigned into either the cognitive impairment group (n=61) or the normal cognitive group (n=71). Gender, age, education, body mass index (BMI), waist hip ratio (WHR), total cholesterol (TC), triglyceride (TG), C-reactive protein (CRP), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), creatinine (Cr), fasting plasma glucose (FPG), fasting insulin (FINS), homeostasis model of assessment for insulin resistance index (HOMA-IR), systolic blood pressure, diastolic blood pressure, smoking history, atherosclerosis and the proportion of uncontrolled hypertension were compared between the two groups. Multi-factorial logistic regression analysis was performed.
  
  
  RESULTS
  No significant differences were found in gender, age, TC, CRP, HDL-C, LDL-C, Cr, BP, smoking history, atherosclerosis and the proportion of uncontrolled hypertension between the two groups. The cognitive impairment group had lower education levels, and higher BMI, WHR, TG, FPG, FINS, and HOMA-IR levels than the control group. Logistic regression analysis revealed the levels of education, BMI, WHR, and HOMA-IR as independent factors that predict cognitive impairment in patients.
  
  
  CONCLUSIONS
  Our study demonstrates that poor education and increased BMI, WHR, and HOMA-IR are independent risk factors for cognitive impairment in elderly patients with hypertension. Insulin resistance plays an important role in the development of cognitive impairment in primary elderly hypertensive patients.
authors.affiliation: Department of Geriatrics, Xuan Wu Hospital, Capital Medical University, Beijing, China.
authors.forename: Lina
authors.initials: L
authors.lastname: Ma
authors.affiliation: Department of Geriatrics, Xuan Wu Hospital, Capital Medical University, Beijing, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Feng
authors.affiliation: Department of Geriatrics, Xuan Wu Hospital, Capital Medical University, Beijing, China.
authors.forename: Yuying
authors.initials: Y
authors.lastname: Qian
authors.affiliation: Department of Geriatrics, Xuan Wu Hospital, Capital Medical University, Beijing, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Yang
authors.affiliation: Department of Geriatrics, Xuan Wu Hospital, Capital Medical University, Beijing, China.
authors.forename: Jia
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Geriatrics, Xuan Wu Hospital, Capital Medical University, Beijing, China.
authors.forename: Rui
authors.initials: R
authors.lastname: Han
authors.affiliation: Department of Geriatrics, Xuan Wu Hospital, Capital Medical University, Beijing, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Zhu
authors.affiliation: Department of Geriatrics, Xuan Wu Hospital, Capital Medical University, Beijing, China. liy_xw@sina.com.
authors.forename: Yun
authors.initials: Y
authors.lastname: Li
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000209:etiology*; D000075222:Essential Hypertension; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D007333:Insulin Resistance; D016015:Logistic Models; D008297:Male; D012307:Risk Factors
keywords: Hypertension; cognitive impairment; elderly; insulin resistance; risk factor