title: Associations between Markers of Glucose and Insulin Function and Cognitive Function in Healthy African American Elders.
abstract: BACKGROUND
  Glucose and insulin are important moderators of cognitive function. African Americans have poorer glycemic control across the glycemic spectrum and are at increased risk for type 2 diabetes and poor cognitive health. It is unclear which glucoregulatory markers predict cognitive function in this at-risk population. The purpose of this study was to examine the association between cognitive function and common markers of glucoregulation in non-diabetic African Americans elders.
  
  
  METHODS
  Thirty-four, community-dwelling African Americans, aged 50-75 years completed cognitive testing and blood collection as part of a health screening assessment. Cognitive outcomes were composite scores derived from neuropsychological tests of executive function and verbal memory. Linear regression was used to examine relationships between cognitive composite scores and fasting blood levels of glucose, insulin, and hemoglobin A1C, with adjustments for age, education, body mass index, and antihypertensive medication use.
  
  
  RESULTS
  Fasting plasma glucose was negatively associated with executive function (β=-0.41, p=0.03). There was a trend of an association between fasting plasma glucose and verbal memory (β=-0.34, p=0.06). Fasting insulin and hemoglobin A1c were not associated with cognitive function.
  
  
  CONCLUSIONS
  High non-diabetic fasting glucose levels were associated with poorer executive function and verbal memory. These results provide preliminary support for proactive glucose control in older African Americans even before glycemic criteria for type 2 diabetes are met. Our findings suggests that high-normal FPG levels may represent an early red-flag to signify increased risk of cognitive impairment or decline.
authors.affiliation: Meharry-Vanderbilt Alliance, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Jeannine S
authors.initials: JS
authors.lastname: Skinner
authors.affiliation: Geriatric Research Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA.
authors.forename: Amy
authors.initials: A
authors.lastname: Morgan
authors.affiliation: Department of Internal Medicine, and Neurology, Wake Forest University Health Sciences, Winston-Salem, NC, USA.
authors.forename: Hector
authors.initials: H
authors.lastname: Hernandez-Saucedo
authors.affiliation: Geriatric Research Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA; Division of Gerontology, Geriatric Medicine, University of Washington School of Medicine, USA.
authors.forename: Angela
authors.initials: A
authors.lastname: Hansen
authors.affiliation: Geriatric Research Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA.
authors.forename: Selena
authors.initials: S
authors.lastname: Corbett
authors.affiliation: Geriatric Research Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Arbuckle
authors.affiliation: Lou Ruvo Center for Brain Health, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
authors.forename: James Ba
authors.initials: JB
authors.lastname: Leverenz
authors.affiliation: Meharry-Vanderbilt Alliance, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Consuelo H
authors.initials: CH
authors.lastname: Wilkins
authors.affiliation: Department of Internal Medicine, and Neurology, Wake Forest University Health Sciences, Winston-Salem, NC, USA.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Craft
authors.affiliation: Department of Internal Medicine, and Neurology, Wake Forest University Health Sciences, Winston-Salem, NC, USA.
authors.forename: Laura D
authors.initials: LD
authors.lastname: Baker
keywords: African Americans; Executive function; Glucose; Memory; Type 2 diabetes