A-18 Early Pattern of Cognitive Changes Associated with Insulin Resistance in a Sample of Young Adults

Abstract

\n \n \n Insulin resistance increases the risk of developing type 2 diabetes and subsequently cardiovascular and cerebrovascular disease. It is also linked to neurocognitive disorders and accelerated cognitive aging (Ekblad et\xa0al, 2017; Levine, Harrati, & Crimmins, 2018). Using baseline data from a longitudinal study in a sample of 126 cognitively intact adults aged 25–50\xa0years (36.5% males), we assessed cognitive performance in relation to insulin resistance to determine whether an early prodromal pattern of cognitive changes exists prior to advanced metabolic disease.\n \n \n \n Steady state plasma glucose (SSPG) was used to measure insulin resistance. Multivariate regression analyses were conducted using age, years of education, body mass index (BMI), and SSPG as predictors of neuropsychological functioning. In-person and tele-neuropsychological assessment was administered using standard neuropsychological measures.\n \n \n \n Higher insulin resistance was associated with significantly worse attention (WAIS-III Digit Span total; B\u2009=\u2009-0.018, p\u2009=\u20090.03), executive functioning (D-KEFS Color-Word Inhibition/Switching; B\u2009=\u20090.047, p\u2009=\u20090.04) and dominant fine motor abilities (Purdue Pegboard; B\u2009=\u2009-0.008, p\u2009=\u20090.02). Higher insulin resistance was also associated with trend level worsening of other measures of executive functioning, namely D-KEFS Trails 4 (B\u2009=\u20090.099, p\u2009=\u20090.07) and DKEFS Color-Word Inhibition errors (B\u2009=\u20090.007, p\u2009=\u20090.09).\n \n \n \n In young adults, higher insulin resistance was associated with declines in attention, executive functioning, and fine motor abilities. This early pattern of subtle cognitive changes associated with higher insulin resistance seen in this sample of younger adults is consistent with later cognitive declines found in type 2 diabetes and vascular neurocognitive disorder, namely declines in attention, executive functioning, and motor abilities with eventual memory declines in advanced disease.\n