title: The Associations among Insulin Resistance, Hyperglycemia, Physical Performance, Diabetes Mellitus, and Cognitive Function in Relatively Healthy Older Adults with Subtle Cognitive Dysfunction.
abstract: Insulin resistance (IR), diabetes mellitus (DM), sarcopenia, and cognitive dysfunction are thought to be mutually associated. We conducted a comprehensive assessment of the relationships among IR, gait speed, hyperglycemia, and DM by cross-sectionally analyzing the baseline data of an interventional study for cognitive preservation with physical exercise (the TOyota Preventional Intervention for Cognitive decline and Sarcopenia [TOPICS]). The participants (n= 444) were relatively healthy older individuals who had mild cognitive impairment without dementia, and 61 of the participants had DM. Slow gait speed and hyperglycemia were associated with cognitive dysfunction, mainly in the executive function domain, whereas IR was associated with memory impairment. The participants with DM had lower general cognition and executive function. Executive dysfunction in the DM participants seemed to be partly explained by hyperglycemia and/or slow gait speed. Our findings confirmed that IR, DM, sarcopenia, and cognitive dysfunction are mutually associated in complex ways. Understanding the mechanisms underlying these associations will lead to effective strategies to prevent and treat cognitive dysfunction in older individuals.
authors.affiliation: Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine Nagoya, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Umegaki
authors.affiliation: Institute of Innovation for Future Society, Nagoya University Nagoya, Japan.
authors.forename: Taeko
authors.initials: T
authors.lastname: Makino
authors.affiliation: Liberal Arts and Sciences, Faculty of Engineering, Toyama Prefectural University Toyama, Japan.
authors.forename: Kazuki
authors.initials: K
authors.lastname: Uemura
authors.affiliation: Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology Obu, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Shimada
authors.affiliation: Institute of Innovation for Future Society, Nagoya University Nagoya, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Hayashi
authors.affiliation: Institute of Innovation for Future Society, Nagoya University Nagoya, Japan.
authors.forename: Xian Wu
authors.initials: XW
authors.lastname: Cheng
authors.affiliation: Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of MedicineNagoya, Japan; Institute of Innovation for Future Society, Nagoya UniversityNagoya, Japan.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Kuzuya
keywords: HOMA-IR; executive function; gait speed; glycihemoglobine; memory; sarcopenia