Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Department of Psychiatry and Behavioral Science, Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
Sci Rep. 2018 Jan 12;8(1):650. doi: 10.1038/s41598-017-18998-0.
We evaluated whether metabolic factors were associated with cognitive decline, compared to baseline cognitive function, among geriatric population. The present study evaluated data from an ongoing prospective community-based Korean cohort study. Among 1,387 participants who were >65 years old, 422 participants were evaluated using the Korean mini-mental status examination (K-MMSE) at the baseline and follow-up examinations. The mean age at the baseline was 69.3 ± 2.9 years, and 222 participants (52.6%) were men. The mean duration of education was 7.1 ± 3.6 years. During a mean follow-up of 5.9 ± 0.1 years, the K-MMSE score significantly decreased (-1.1 ± 2.7 scores), although no significant change was observed in the homeostasis model assessment of insulin resistance (HOMA-IR) value. Participants with more decreased percent changes in K-MMSE scores had a shorter duration of education (p = 0.001), older age (p = 0.022), higher baseline K-MMSE score (p < 0.001), and increased insulin resistance (∆HOMA-IR, p = 0.002). The correlation between the percent changes in K-MMSE and ∆HOMA-IR values remained significant after multivariable adjustment (B = -0.201, p = 0.002). During a 6-year follow-up of older Koreans with normal baseline cognitive function, increased insulin resistance was significantly correlated with decreased cognitive function.
我们评估了代谢因素与老年人认知能力下降的关系，与基线认知功能相比。本研究评估了一项正在进行的基于社区的韩国队列研究的数据。在 1387 名年龄>65 岁的参与者中，有 422 名参与者在基线和随访检查中接受了韩国迷你精神状态检查（K-MMSE）评估。基线时的平均年龄为 69.3±2.9 岁，222 名参与者（52.6%）为男性。平均受教育年限为 7.1±3.6 年。在平均 5.9±0.1 年的随访期间，K-MMSE 评分显著下降（-1.1±2.7 分），尽管胰岛素抵抗稳态模型评估（HOMA-IR）值没有明显变化。K-MMSE 评分百分比变化较大的参与者受教育时间较短（p=0.001）、年龄较大（p=0.022）、基线 K-MMSE 评分较高（p<0.001）和胰岛素抵抗增加（∆HOMA-IR，p=0.002）。在多变量调整后，K-MMSE 和 ∆HOMA-IR 值的百分比变化之间的相关性仍然显著（B=-0.201，p=0.002）。在对基线认知功能正常的韩国老年人进行的 6 年随访中，胰岛素抵抗的增加与认知功能的下降显著相关。
