Impact of impaired fasting glucose and other metabolic factors on cognitive function in elderly people P. Di Bonito a, *, L. Di Fraia a , L. Di Gennaro a , A. Vitale a , M. Lapenta a , A. Scala a , M.R. Iardino b , B. Cusati c , L. Attino d , B. Capaldo e a Department of Internal Medicine, ‘‘S. Maria delle Grazie’’ Pozzuoli Hospital, Via Domitiana Loc. La Schiana, 80078 Pozzuoli, Naples, Italy b Department of Clinical Pathology, ‘‘S. Maria delle Grazie’’ Hospital, 80078 Pozzuoli, Naples, Italy c Department of Radiology, ‘‘S. Maria delle Grazie’’ Hospital, 80078 Pozzuoli, Naples, Italy d District 54 ASL Na2, Federico II University, Naples, Italy e Department of Clinical and Experimental Medicine, Federico II University, Naples, Italy Received 20 May 2005; received in revised form 6 July 2005; accepted 6 July 2005 KEYWORDS Cognitive function; Impaired fasting glucose; Homocysteine; Insulin resistance; Diabetes; Dementia Abstract Aim: The present study was undertaken to evaluate the impact of im- paired fasting glucose (IFG), insulin resistance (IR) and hyperhomocysteinaemia (Hhcy) on cognitive function (CF) in a sample of non-diabetic elderly subjects. Methods and results: One hundred and eighty-two non-diabetic subjects, aged  65 years, without signs of previous stroke were included in the study. CF was evaluated by the Mini Mental State Examination (MMSE) score, corrected for age and educa- tion. Since diagnostic criteria for IFG have been recently lowered from 110 to 100 mg/dl, subjects were categorized according to old (IFG 1997 ) and new (IFG 2003 ) criteria. IR and Hhcy were defined by the upper quartile of insulin (11.0 UI/L) and Hcy (18.6 mmol/L) distribution, respectively. The frequency of IFG 1997 , Hhcy, and IR, but not of IFG 2003 , showed a linear trend across tertiles of MMSE (p < 0.001). The odds ratio (95% CI) for impaired CF (MMSE < 24.3) was 9.08 (2.97e 27.74) for IFG 1997 , 3.66 (1.28e10.45) for Hhcy, 2.83 (1.25e6.37) for IR and 1.32 (0.61e2.89) for IFG 2003 . Conclusions: Our study shows that IFG 1997 , Hhcy and IR are powerful metabolic markers of impaired CF among elderly people. ª 2005 Elsevier B.V. All rights reserved. * Corresponding author. Tel.: þ39 081 8552281. E-mail address: diabetologia.po54@asl2.napoli.it (P. Di Bonito). 0939-4753/$ - see front matter ª 2005 Elsevier B.V. All rights reserved. doi:10.1016/j.numecd.2005.07.011 Nutrition, Metabolism & Cardiovascular Diseases (2007) 17, 203e208 www.elsevier.com/locate/nmcd