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Relationship between Insulin-Resistance Processing Speed and Specific Executive Function Profiles in Neurologically Intact Older Adults

Published online by Cambridge University Press:  14 August 2015

Darvis T. Frazier ,
Brianne M. Bettcher ,
Shubir Dutt ,
Nihar Patel ,
Dan Mungas ,
Joshua Miller ,
Ralph Green  and
Joel H. Kramer
Darvis T. Frazier*
Affiliation:
Memory and Aging Center, University of California, San Francisco, San Francisco, California Department of Neurology, University of California, San Francisco, San Francisco, California
Brianne M. Bettcher
Affiliation:
Memory and Aging Center, University of California, San Francisco, San Francisco, California Department of Neurology, University of California, San Francisco, San Francisco, California
Shubir Dutt
Affiliation:
Memory and Aging Center, University of California, San Francisco, San Francisco, California Department of Neurology, University of California, San Francisco, San Francisco, California
Nihar Patel
Affiliation:
Memory and Aging Center, University of California, San Francisco, San Francisco, California Department of Neurology, University of California, San Francisco, San Francisco, California
Dan Mungas
Affiliation:
Department of Neurology, School of Medicine, University of California, Davis, Davis, California
Joshua Miller
Affiliation:
Department of Pathology and Laboratory Medicine, University of California, Davis, Davis, California
Ralph Green
Affiliation:
Department of Pathology and Laboratory Medicine, University of California, Davis, Davis, California
Joel H. Kramer
Affiliation:
Memory and Aging Center, University of California, San Francisco, San Francisco, California Department of Neurology, University of California, San Francisco, San Francisco, California
*
Correspondence and reprint requests to: Darvis T. Frazier, UCSF Memory and Aging Center, 675 Nelson Rising Lane, Suite 190 San Francisco, CA 94143-1207. E-mail: dfrazier@memory.ucsf.edu
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Abstract

This study investigated the relationship between insulin-resistance and constituent components of executive function in a sample of neurologically intact older adult subjects using the homeostasis model assessment (HOMA-IR) and latent factors of working memory, cognitive control and processing speed derived from confirmatory factor analysis. Low-density lipoprotein (LDL), mean arterial pressure (MAP), along with body mass index (BMI) and white matter hypointensity (WMH) were used to control for vascular risk factors, adiposity and cerebrovascular injury. The study included 119 elderly subjects recruited from the University of California, San Francisco Memory and Aging Center. Subjects underwent neuropsychological assessment, fasting blood draw and brain magnetic resonance imaging (MRI). Partial correlations and linear regression models were used to examine the HOMA-IR-executive function relationship. Pearson correlation adjusting for age showed a significant relationship between HOMA-IR and working memory (rp=−.18; p=.047), a trend with cognitive control (rp=−.17; p=.068), and no relationship with processing speed (rp=.013; p=.892). Linear regression models adjusting for demographic factors (age, education, and gender), LDL, MAP, BMI, and WMH indicated that HOMA-IR was negatively associated with cognitive control (r=−.256; p=.026) and working memory (r=−.234; p=.054). These results suggest a greater level of peripheral insulin-resistance is associated with decreased cognitive control and working memory. After controlling for demographic factors, vascular risk, adiposity and cerebrovascular injury, HOMA-IR remained significantly associated with cognitive control, with working memory showing a trend. These findings substantiate the insulin-resistance-executive function hypothesis and suggest a complex interaction, demonstrated by the differential impact of insulin-resistance on processing speed and specific aspects of executive function. (JINS, 2015, 21, 622–628)

Keywords

Homeostatic model assessmentInsulin-resistanceConfirmatory factor analysisExecutive functionWorking memoryCognitive controlProcessing speedWhite matter hypointensity
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 21 , Issue 8 , September 2015 , pp. 622 - 628
Copyright
Copyright © The International Neuropsychological Society 2015 

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