Abstract P366: Fasting Glucose and Insulin Resistance Trajectories in Young Adulthood and Cognitive Function in Middle Adulthood: the Coronary Artery Risk Development in Young Adults (CARDIA) Study

Abstract

Introduction: Whether multiple unique trajectories in fasting glucose (FG) and insulin resistance (HOMA-IR) are present during young adulthood and if such trajectories are associated with cognitive function in middle adulthood is unclear. Hypothesis: We hypothesized that a high-increasing trajectory of FG and HOMA-IR in the absence of diabetes during young adulthood would be associated with lower level of cognitive function in midlife compared to a low trajectory. Methods: We studied 2,650 CARDIA participants, age 18 to 30 years (1985-1986) to determine FG and HOMA-IR at baseline and 7, 10, 15, and 20 year follow-up exams (≥ 8 hours fasting and not pregnant). Using latent class analysis (SAS Proc Traj), we determined trajectory groups for FG and HOMA-IR through year 20. Cognitive function was assessed at year 25 (2010-2011) with three cognitive tests including the Digit Symbol Substitution Test (DSST; a test of sustained attention, psychomotor speed, working memory, and executive function), Rey-Auditory Verbal Learning Test (RAVLT; verbal memory), and Stroop Test (executive function). We used multivariable linear regression to estimate adjusted means for each cognitive test according to trajectory group for both FG and HOMA-IR for individuals free from diabetes during follow-up, after adjustment for potential confounding factors. Results: We identified three trajectory groups for FG and HOMA-IR for individuals free from diabetes in middle adulthood, qualitatively low-stable to increasing, moderate-increasing, and high-increasing. Compared to the low FG trajectory group, the high FG trajectory group had significantly lower mean score for the RAVLT, shown in the Table . Otherwise, cognitive test scores generally did not differ according to FG or HOMA-IR trajectory group. Conclusion: In this community-based sample of individuals free from diabetes, a high-increasing FG trajectory through young adulthood was associated with worse memory in midlife.