title: Cognitive impairment is correlated with insulin resistance degree: the "PA-NICO-study".
abstract: Several epidemiological studies have shown that Diabetes Mellitus (DM) or Insulin Resistance (IR) increases the risk of dementia. Besides, some authors suggested that poor glucose control to be associated with worse cognitive function. We aimed to assess cognitive functions and IR-degree over time in diabetic. We also evaluated whether a greater magnitude of cognitive decline could be related with their IR degree. We enrolled 335 diabetic patients and 142 non-diabetic subjects; participants were subdivided into three groups in accordance with their IRdegree assessed by Homa-Index (HI): Normal-HI (non-diabetic NHI < 2,6), Moderate-HI (MHI > 2,6 < 10) and High-HI (HHI > 10). Metabolic status and a comprehensive neuropsycological test battery (MMSE, ADAS-Cog, ACDS-ADL) were assessed at baseline and every 12-months during the follow-up (6,8 years). At the end of the study, the average MMSE decreased significantly in patients of HHI group (P = .001) compared to baseline. MMSE scores were also reduced both in MHI group and in controls, but the difference between two groups was not significant. In HHI group, similar effects were observed for the ADAS-Cog score compared to baseline (P = 0.001); instead, when ACDS-ADL was evaluated, no differences was observed among the three groups. These results remained unchanged also after adjustment for confounding variables (i.e. APOε-status, sex, BMI, education level, heart diseases and HbA1c). We suggest that higher IR-degree is associated with greater cognitive decline in diabetic patients; so we hypothesize that IR degree, more than IR status itself, could be related to the severity of cognitive impairment.
authors.affiliation: Department of Clinical and Experimental Medicine, University of Catanzaro, 88100, Catanzaro, Italy.
authors.forename: Antonietta
authors.initials: A
authors.lastname: Fava
authors.affiliation: Institute of Neurological Science - National Research Council, Roccelletta di Borgia, 88100, Catanzaro, Italy.
authors.forename: Carmen
authors.initials: C
authors.lastname: Colica
authors.affiliation: Department of Neuroscience, "S. Giovanni di Dio" Hospital, Largo Bologna, 88900, Crotone, Italy.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Plastino
authors.affiliation: Department of Neuroscience, "S. Giovanni di Dio" Hospital, Largo Bologna, 88900, Crotone, Italy.|Institute of Neurological Science - National Research Council, UVS-IBFM, 02, Milan, Italy.
authors.forename: Demetrio
authors.initials: D
authors.lastname: Messina
authors.affiliation: Department of Neuroscience, "S. Giovanni di Dio" Hospital, Largo Bologna, 88900, Crotone, Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: Cristiano
authors.affiliation: Department of Neuroscience, "S. Giovanni di Dio" Hospital, Largo Bologna, 88900, Crotone, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Opipari
authors.affiliation: Department of Neuroscience, "S. Giovanni di Dio" Hospital, Largo Bologna, 88900, Crotone, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Vaccaro
authors.affiliation: Department of Neuroscience, "S. Giovanni di Dio" Hospital, Largo Bologna, 88900, Crotone, Italy.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Gorgone
authors.affiliation: University of Pharmacology, loc. Roccelletta, University "Magna Graecia", 88100, Catanzaro, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Bosco
authors.affiliation: Department of Neuroscience, "S. Giovanni di Dio" Hospital, Largo Bologna, 88900, Crotone, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Fratto
authors.affiliation: Service of Neurophysiology, Hospital, 87067, Rossano, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: De Bartolo
authors.affiliation: Department of Neuroscience, "S. Giovanni di Dio" Hospital, Largo Bologna, 88900, Crotone, Italy. nico_bosco@libero.it.
authors.forename: Domenico
authors.initials: D
authors.lastname: Bosco
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D060825:Cognitive Dysfunction / Q000097:blood / Q000453:epidemiology* / Q000523:psychology*; D003920:Diabetes Mellitus / Q000097:blood / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011446:Prospective Studies
keywords: Alzheimer disease; Cognitive impairment; Insulin resistance