Hyperinsulinemia and risk of Alzheimer disease

  • Luchsinger J
  • Tang M
  • Shea S
 et al. 
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OBJECTIVE: To explore the association between fasting insulin levels and dementia. METHODS: Fasting insulin levels were measured from frozen sera using solid-phase chemiluminescent enzyme immunoassay in a sample of elderly subjects chosen at random from a cohort of persons aged 65 years and older from northern Manhattan. Dementia was diagnosed using standard methods. Neuropsychiatric testing was available on all subjects at each follow-up interval. RESULTS: A total of 683 subjects without prevalent dementia were followed for 3,691 person-years and 149 persons developed dementia (137 Alzheimer disease [AD], 6 dementia associated with stroke, 6 other). The risk of AD doubled in the 39% of the sample with hyperinsulinemia (HR = 2.1; 95% CI: 1.5, 2.9) and was highest in people without diabetes. The HR relating presence of hyperinsulinemia or diabetes in 50% of our sample to AD was 2.2 (95% CI: 1.5, 3.1). The risk of AD attributable to the presence of hyperinsulinemia or diabetes was 39%. The HR of AD for the highest quartile of insulin compared to the lowest was 1.7 (95% CI: 1.0, 2.7; p for trend = 0.009). Hyperinsulinemia was also related to a significant decline in memory-related cognitive scores, but not to decline in other cognitive domains. CONCLUSIONS: Hyperinsulinemia is associated with a higher risk of AD and decline in memory.

Author-supplied keywords

  • *Alzheimer Disease/bl [Blood]
  • *Hyperinsulinism/px [Psychology]
  • 0 (Apolipoprotein E4)
  • 0 (Apolipoproteins E)
  • Aged
  • Aged, 80 and over
  • Alzheimer Disease/eh [Ethnology]
  • Alzheimer Disease/et [Etiology]
  • Apolipoprotein E4
  • Apolipoproteins E/bl [Blood]
  • Cognition
  • Cross-Sectional Studies
  • Dementia/bl [Blood]
  • Dementia/et [Etiology]
  • Diabetes Mellitus/px [Psychology]
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Odds Ratio
  • Prevalence
  • Proportional Hazards Models
  • Risk Factors
  • Stroke/co [Complications]

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  • J A Luchsinger

  • M X Tang

  • S Shea

  • R Mayeux

  • Jose A Luchsinger

  • Ming-Xin Tang

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