Fasting insulin and incident dementia in an elderly population of Japanese-American men

Peila, Rita; Rodriguez, Beatriz L.; White, Lon R.; Launer, Lenore J.

doi:10.1212/01.wnl.0000129989.28404.9b

Cited by 152Dementia and Cognitive Impairment ResearchDiabetes, Cardiovascular Risks, and LipoproteinsAdipokines, Inflammation, and Metabolic Diseases

Fasting insulin and incident dementia in an elderly population of Japanese-American men

Peila, Rita, Rodriguez, Beatriz L., White, Lon R., Launer, Lenore J.·2004·Neurology

DOI 10.1212/01.wnl.0000129989.28404.9b

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Abstract

OBJECTIVE: To evaluate the association of fasting insulin level to incident dementia in a cohort of elderly men. METHODS: Data are from the Honolulu-Asia Aging Study, a community-based study of Japanese-American men, aged 71 to 91 years in 1991. Serum insulin was measured in 1991 and participants were grouped based on their insulin levels. Dementia was ascertained in 1991, 1994, and 1996 according to international guidelines. The 2,568 men dementia-free in 1991 were reexamined in 1994 and 1996; 244 new cases of dementia were diagnosed. Survival analysis with age as the time scale was used to estimate the risk (hazard ratio [HR] and 95% CI) for incident dementia associated with levels of insulin. RESULTS: The risk of dementia was increased at the two extremes of the insulin distribution (lower and upper 15th percentiles). Compared to the rest of the cohort subjects in the lowest 15th percentile and highest 15th percentile had an increased risk for dementia (HR = 1.54, CI 1.11 to 2.11 and HR = 1.54, CI 1.05 to 2.26). In men with insulin levels <22.2 mIU/L the risk for dementia decreased with increased levels of insulin (HR = 0.76, CI 0.72 to 0.79 for each increase of one logarithmic unit -2.72 mIU/L of insulin). In men with insulin levels >/=22.2 mIU/L the risk for dementia increased with increasing levels of insulin (HR = 1.64, CI = 1.07 to 2.52 for each 2.72 mIU/L). CONCLUSIONS: Both low and high levels of insulin are associated with an increased risk of developing dementia.

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Metformin is efficacious in treating and preventing diabetes while reducing hyperinsulinemia.
“metformin, a medication efficacious in treating and preventing diabetes while reducing hyperinsulinemia”
From Metformin in Amnestic Mild Cognitive Impairment: Results of a Pilot Randomized Placebo Controlled Clinical Trial (2016) · cites this paper as [26]
Metformin is a safe, inexpensive medication available in generic form with proven efficacy in treating and preventing type 2 diabetes through reduction of peripheral glucose and insulin levels.
“Metformin is a safe, inexpensive medication available in generic form with proven efficacy in treating and preventing T2D though the reduction of peripheral glucose and insulin levels [25, 26].”
From Metformin in Amnestic Mild Cognitive Impairment: Results of a Pilot Randomized Placebo Controlled Clinical Trial (2016) · cites this paper as [26]
Hyperinsulinemia is related to a higher risk of Alzheimer's disease.
“Several studies have shown that hyperinsulinemia, a consequence of higher adiposity and insulin resistance, is also related to a higher risk of Alzheimer’s disease.”
From Adiposity, hyperinsulinemia, diabetes and Alzheimer's disease (2008) · cites this paper as Peila et al., 2004

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Authors: Peila, R., Rodriguez, B. L., White, L. R., & Launer, L. J.
Affiliations: University of Hawaiʻi at Mānoa (US)
From the Laboratory of Epidemiology, Demography and Biometry (Drs. Peila and Launer), National Institute on Aging, National Institutes of Health, Bethesda, MD; Clinical Epidemiology and Geriatric Division (Drs. Rodriguez and White), Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu; and Pacific Health Research Institute (Dr. White), Manoa, Honolulu, HI.
ORCID: Peila, Rita
White, Lon R.
Launer, Lenore J.
Venue: Neurology
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2004-07-27
Volume: 63
Issue: 2
Pages: 228-233
ISSN: 0028-3878 (ISSN-L)
1526-632X
DOI: 10.1212/01.wnl.0000129989.28404.9b
OpenAlex: W1981357357
Cited by: 152
References: 45
Citations by year: 2026: 1 · 2025: 3 · 2024: 3 · 2023: 5 · 2022: 2 · 2021: 6 · 2020: 1 · 2019: 14 · 2018: 11 · 2017: 7 · 2016: 9 · 2015: 4 · 2014: 6 · 2013: 6 · 2012: 8
FWCI: 3.94
Type: journal article
Language: en
Open access: closed
Locations: Neurology (publishedVersion)
PubMed (publishedVersion)
Funders: U.S. Department of Veterans Affairs
National Institutes of Health (n01hc005102-027)
National Institute on Aging (N01‐AG‐4‐2149)
National Heart, Lung, and Blood Institute (N01-HC-O5102)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
Keywords: fasting insulin, incident dementia, Japanese-American men, older men, insulin levels, dementia risk, Honolulu-Asia Aging Study, hyperinsulinemia, hypoinsulinemia
MeSH terms: Aged, Aged, 80 and over, Asian, Dementia, Diabetes Mellitus, Fasting, Hawaii, Humans, Hyperinsulinism, Insulin, Male, Prospective Studies, Risk Factors, Socioeconomic Factors, Cohort Studies, Confounding Factors, Epidemiologic, Proportional Hazards Models, Glucose Intolerance

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Fasting insulin and incident dementia in an elderly population of Japanese-American men

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