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Aim: To study the association between Insulin Resistance (IR) and Glycosylated hemoglobin (HbA1c) and cognition in frail, pre-frail and non-frail elderly. Method: A case control study was conducted on 85 subjects: 60 cases (37 frail and 23 pre-frail subjects) and 25 controls. All subjects underwent comprehensive geriatric assessment including a battery of cognitive tests. Laboratory data included Serum insulin levels, Fasting Blood Sugar, Insulin like Growth Factor-1, C-Reactive Protein (CRP) and HbA1c. Results: Among the pre-frail subjects, Homeostasis Model of Assessment-Insulin resistance (HOMA-IR) and insulin level were positively correlated with Digit Span Backward (DSB) (p = 0.012 and 0.045 respectively). HbA1c was positively correlated with Contrast Programming (CP) (p = 0.01). Controls showed a positive correlation between HOMA-IR and CP, DSB and Mini-Mental Status Examination (P = 0.009, 0.03 and 0.002 respectively). There was no significant correlation in the frail group. Conclusion: In the studied sample, higher insulin, HbA1c, and IR were associated with better cognitive functions in prefrail elderly, and were not associated with worse cognition in frail elderly.

Insulin Resistance and Cognitive Functions in a Sample of Prefrail, Frail and Non-Frail Elderly