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Hyperinsulinemia and risk of Alzheimer disease
Luchsinger JA, Tang MX, Shea S, Mayeux R.. Neurology, 2004-10-01
Topic: Amyloid, tau and blood-test diagnosis
Plain-language summary
Objective To explore the association between fasting insulin levels and dementia. Methods Fasting insulin levels were measured from frozen sera using solid-phase chemiluminescent enzyme immunoassay in a sample of elderly subjects chosen at random from a cohort of persons aged 65 years and older from northern Manhattan. Dementia was diagnosed using standard methods. Neuropsychiatric testing was available on all subjects at each follow-up interval. Results A total of 683 subjects without prevalent dementia were followed for 3,691 person-years and 149 persons developed dementia (137 Alzheimer disease [AD], 6 dementia associated with stroke, 6 other). The risk of AD doubled in the 39% of the sample with hyperinsulinemia (HR = 2.1; 95% CI: 1.5, 2.9) and was highest in people without diabetes. The HR relating presence of hyperinsulinemia or diabetes in 50% of our sample to AD was 2.2 (95% CI: 1.5, 3.1). The risk of AD attributable to the presence of hyperinsulinemia or diabetes was 39%. The HR of AD for the highest quartile of insulin compared to the lowest was 1.7 (95% CI: 1.0, 2.7; p for trend = 0.009). Hyperinsulinemia was also related to a significant decline in memory-related cognitive scores, but not to decline in other cognitive domains. Conclusions Hyperinsulinemia is associated with a higher risk of AD and decline in memory.
What this study adds
Evidence grade: Moderate
The record lists 683 participants. High insulin was also tied to faster decline in memory scores, but not in other thinking skills. Reported effect size: HR = 2.1.
Taken from this record’s own fields, not from reading the paper. The grade is assigned from the abstract’s wording; what that means.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Luchsinger, J. A., Tang, M. X., Shea, S., & Mayeux, R. (2004). Hyperinsulinemia and risk of Alzheimer disease. Neurology. https://doi.org/10.1212/01.wnl.0000140292.04932.87
Vancouver
Luchsinger JA, Tang MX, Shea S, Mayeux R. Hyperinsulinemia and risk of Alzheimer disease. Neurology. 2004. doi:10.1212/01.wnl.0000140292.04932.87. PMID: 15477536.
BibTeX
@article{luchsinger2004-15477536,
author = {Luchsinger, J. A. and Tang, M. X. and Shea, S. and Mayeux, R.},
title = {{Hyperinsulinemia and risk of Alzheimer disease}},
journal = {Neurology},
year = {2004},
doi = {10.1212/01.wnl.0000140292.04932.87},
pmid = {15477536},
url = {https://doi.org/10.1212/01.wnl.0000140292.04932.87}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
Key findings
- Results A total of 683 subjects without prevalent dementia were followed for 3,691 person-years and 149 persons developed dementia (137 Alzheimer disease [AD], 6 dementia associated with stroke, 6 other).
- The HR of AD for the highest quartile of insulin compared to the lowest was 1.7 (95% CI: 1.0, 2.7; p for trend = 0.009).
- Hyperinsulinemia was also related to a significant decline in memory-related cognitive scores, but not to decline in other cognitive domains.
- Conclusions Hyperinsulinemia is associated with a higher risk of AD and decline in memory.
Why it matters
In 683 people aged 65 and older from northern Manhattan who did not have dementia at the start, those with high fasting insulin (39% of the group) went on to develop Alzheimer's disease at about twice the rate of the others (hazard ratio 2.1, 95% CI 1.5–2.9), and the link was strongest in people without diabetes. High insulin was also tied to faster decline in memory scores, but not in other thinking skills. This is an observational association: the study did not test whether lowering insulin changes anyone's risk.
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Study details
- Participants683
- Effect sizeHR = 2.1
- Evidence strengthModerate
How this study scored 63/100
Published in a leading specialty journal. Scored zero for study design and randomized / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Neurology) |
| Journal's citation record | 4 / 4 | Neurology: journal h-index 525 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2004 — older than 20 years, still counted |
| Sample size | 2 / 4 | 683 participants |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 6 / 7 | Cited 683 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 28.5 citations a year over 24 year(s) since 2004 |
| Impact for its field and year | 4 / 6 | Cited 18.8× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 4 / 6 | Cited by 42 other studies in this library |
| Still being cited | 2 / 4 | Cited 35 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Richard P Mayeux: h-index 158 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Columbia University: institution h-index 1,824 (OpenAlex) |
| Multicenter collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 15477536) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 63 / 100 | — |
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