{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T16:24:53Z","timestamp":1792167893275,"version":"4.4.0"},"reference-count":39,"publisher":"American Diabetes Association","issue":"6","license":[{"start":{"date-parts":[[2017,5,22]],"date-time":"2017-05-22T00:00:00Z","timestamp":1495411200000},"content-version":"vor","delay-in-days":47,"URL":"http:\/\/www.diabetesjournals.org\/content\/license"}],"funder":[{"DOI":"10.13039\/100010114","name":"Yrj\u00f6 Jahnssonin S\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010114","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007417","name":"Paulon S\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007417","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008320","name":"Suomen Aivos\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008320","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2017,6,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>The aim of this study was to examine whether insulin resistance, assessed by HOMA of insulin resistance (HOMA-IR), is an independent predictor of cognitive decline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                    <jats:p>The roles of HOMA-IR, fasting insulin and glucose, HbA1c, and hs-CRP as predictors of cognitive performance and its change were evaluated in the Finnish nationwide, population-based Health 2000 Health Examination Survey and its 11-year follow-up, the Health 2011 study (n = 3,695, mean age at baseline 49.3 years, 55.5% women). Categorical verbal fluency, word-list learning, and word-list delayed recall were used as measures of cognitive function. Multivariate linear regression analysis was performed and adjusted for previously reported risk factors for cognitive decline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Higher baseline HOMA-IR and fasting insulin levels were independent predictors of poorer verbal fluency performance (P = 0.0002 for both) and of a greater decline in verbal fluency during the follow-up time (P = 0.004 for both). Baseline HOMA-IR and insulin did not predict word-list learning or word-list delayed recall scores. There were no interactions between HOMA-IR and apolipoprotein E \u03b54 (APOE\u03b54) genotype, hs-CRP, or type 2 diabetes on the cognitive tests. Fasting glucose and hs-CRP levels at baseline were not associated with cognitive functioning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Our results show that higher serum fasting insulin and insulin resistance predict poorer verbal fluency and a steeper decline in verbal fluency during 11 years in a representative sample of an adult population. Prevention and treatment of insulin resistance might help reduce cognitive decline later in life.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2337\/dc16-2001","type":"journal-article","created":{"date-parts":[[2017,4,5]],"date-time":"2017-04-05T20:40:19Z","timestamp":1491424819000},"page":"751-758","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":119,"title":["Insulin Resistance Predicts Cognitive Decline: An 11-Year Follow-up of a Nationally Representative Adult Population Sample"],"prefix":"10.2337","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5863-8088","authenticated-orcid":false,"given":"Laura L.","family":"Ekblad","sequence":"first","affiliation":[{"name":"Turku PET Centre, University of Turku, Turku, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juha O.","family":"Rinne","sequence":"additional","affiliation":[{"name":"Turku PET Centre, University of Turku, Turku, Finland"},{"name":"Division of Clinical Neurosciences, Turku University Hospital, Turku, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pauli","family":"Puukka","sequence":"additional","affiliation":[{"name":"National Institute for Health and Welfare, Turku, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanna","family":"Laine","sequence":"additional","affiliation":[{"name":"Turku City Hospital, University of Turku, Turku, Finland"},{"name":"Department of Medicine, Turku University Hospital, University of Turku, Turku, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satu","family":"Ahtiluoto","sequence":"additional","affiliation":[{"name":"University of Eastern Finland, Kuopio, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raimo","family":"Sulkava","sequence":"additional","affiliation":[{"name":"University of Eastern Finland, Kuopio, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matti","family":"Viitanen","sequence":"additional","affiliation":[{"name":"Turku City Hospital, University of Turku, Turku, Finland"},{"name":"Clinical Geriatrics, Karolinska Institutet, Karolinska University Hospital, Huddinge, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antti","family":"Jula","sequence":"additional","affiliation":[{"name":"National Institute for Health and Welfare, Turku, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2017,4,5]]},"reference":[{"key":"2022031301435521900_B1","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1016\/j.jalz.2007.04.381","article-title":"Forecasting the global burden of Alzheimer\u2019s disease","volume":"3","author":"Brookmeyer","year":"2007","journal-title":"Alzheimers Dement"},{"key":"2022031301435521900_B2","doi-asserted-by":"crossref","first-page":"1937","DOI":"10.1212\/WNL.53.9.1937","article-title":"Diabetes mellitus and the risk of dementia: The Rotterdam Study","volume":"53","author":"Ott","year":"1999","journal-title":"Neurology"},{"key":"2022031301435521900_B3","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/S1474-4422(05)70284-2","article-title":"Risk of dementia in diabetes mellitus: a systematic review","volume":"5","author":"Biessels","year":"2006","journal-title":"Lancet Neurol"},{"key":"2022031301435521900_B4","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1111\/j.1445-5994.2012.02758.x","article-title":"Diabetes as a risk factor for dementia and mild cognitive impairment: a meta-analysis of longitudinal studies","volume":"42","author":"Cheng","year":"2012","journal-title":"Intern Med J"},{"key":"2022031301435521900_B5","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1016\/S2213-8587(13)70088-3","article-title":"Dementia and cognitive decline in type 2 diabetes and prediabetic stages: towards targeted interventions","volume":"2","author":"Biessels","year":"2014","journal-title":"Lancet Diabetes Endocrinol"},{"key":"2022031301435521900_B6","doi-asserted-by":"crossref","first-page":"1595","DOI":"10.2337\/diab.37.12.1595","article-title":"Banting lecture 1988. 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