According to a recent study, people without diabetes but with higher levels of blood sugar and body fat – two risk factors of diabetes – may be more likely to have poor cognitive function compared to those with lower levels. That is, these otherwise healthy people may not process thoughts as quickly as others when they have these risk factors.

Caroline M. Sanz, MD, of the University of Toulouse III in France, and colleagues wanted to see if there was a link between risk factors of diabetes and cognitive performance (processing speed) in middle-aged adults without diabetes.

The specific diabetes risk factors used in the study were:

• insulin resistance – a condition in which the body does not properly use the hormone insulin, which helps the body manage blood sugar levels
• adiposity, or a type of tissue that stores fat, which was measured as BMI (a measure of body fat using height and weight), waist size and body fat
• HbA1c – a measure of blood sugar levels over the past 3 months

To measure cognitive function, the researchers used four tests that assessed processing speed, or how quickly participants processed thoughts. These tests included:

• Word-list learning test – participants are asked to remember a list of words
• Digit symbol substitution test – participants are asked to match numbers to a corresponding symbol within a certain amount of time
• Word fluency test – participants are asked to write or say as many words as possible from a specific category in a certain amount of time

Results showed that participants with the highest BMI were about twice as likely to get the lowest scores on the cognitive function tests. More specifically, the odds ratio for poor cognitive function was 2.18 for participants with the highest BMI compared to those with the lowest BMI. In other words, they had 2.18 times the odds of poor test scores.

An odds ratio explains how much an event happens in one group versus another. An odds ratio of more than 1.0 means that event happens more in the first group than in the second.

Participants with high HbA1c had 1.75 times the odds of poor scores on the digit symbol substitution test, compared to those with lower HbA1c. Waist circumference was tied to poor cognitive function in men but not women.

”Poor cognitive performance is associated with adiposity and hyperglycemia [high blood sugar] in healthy middle-aged people,” the authors concluded.

The study included 1,172 people aged 35 to 64 years without diabetes.

Diabetes Care, Dec 28, 2012

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