Cognitive Disease, Metabolic Disease, and Inflammation in the Honolulu Asia Aging Study: Connnecting the Dots between Insulin Resistance, Type 2 Diabetes, Alzheimer's Disease, Dementia, and Fibrinogen.

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2017-05
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Lee, Thomas H. W.
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Epidemiology
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Metabolic diseases and cognitive diseases are two of the leading causes of morbidity and mortality worldwide. As medical technology and research continues to evolve and improve, the proportion of persons over 65 years of age will continue to increase. This dissertation presents analysis aimed to understand connections between inflammation, insulin resistance, type 2 diabetes, and Alzheimer’s disease/dementia. The first study looks at the relationship between insulin resistance and Alzheimer’s disease/dementia. The relationship between inflammation, via fibrinogen, and insulin resistance is investigated in the second study. Finally, the third study investigates the association between fibrinogen and type 2 diabetes. This dissertation utilized data from the Honolulu Asia Aging study, a longitudinal cohort of Japanese-American men who were identified using 1960 U.S. Census data and selective service registration records from World War II. The author found that subjects who were insulin resistant at later life had decreased odds of Alzheimer’s disease and dementia. Carriers of the APOE ε4 allele had at 50% increased odds of dementia and 60% increased odds of Alzheimer’s disease. Subjects with elevated fibrinogen levels at later life observed increased odds of prevalent insulin resistance and type 2 diabetes, even after adjusting for potential confounders.
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