Interaction of sex and insulin resistance with cognitive impairment in community-dwelling middle-aged and older adults
- 1Division of Population Health Research, Department of Precision Medicine, Korea National Institute of Health , , ,
- 2Department of Preventive Medicine, Korea University College of Medicine , ,
Abstract
Introduction: Cognitive impairment is a major global health challenge. However, whether sex and age interactively varies the association between insulin resistance and cognitive impairment remains unclear. This cross-sectional study aimed to evaluate the association between insulin resistance and cognitive impairment and identify sex- and age-specific interactions in community-dwelling adults.
Methods: The study involved 3,898 participants (aged 54–86 years) from the Ansan-Ansung cohort of the Korean Genome and Epidemiology Study (2017–2018). Insulin resistance was assessed via Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), with participants dichotomized by the median (1.97). Cognitive impairment was defined as a score of ≤23 on the Korean Mini-Mental State Examination score. Multivariable logistic regression was applied to examine the interaction and stratified effects of sex and age (≥65 vs. <65 years) on the insulin resistance–cognitive impairment association.
Results: Among 3,898 participants (mean age 66.6 years; 55.5% women), 635 (16.3%) had cognitive impairment. A significant interaction was observed between sex and HOMA-IR (p = 0.04), whereas the interaction for age was not significant (p = 0.17). In stratified analyses, higher HOMA-IR was significantly associated with cognitive impairment exclusively in women aged ≥65 years (OR 1.37; 95% CI 1.02–1.84; p = 0.04).
Conclusion: Higher insulin resistance is a significant modifiable factor for cognitive impairment, specifically in women aged ≥65 years. These exploratory findings suggest potential sex-related differences in the metabolic-cognitive association, underscoring the importance of sex-specific metabolic management starting from midlife to help preserve cognitive health in later life.
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BibTeX
@article{kim2026interaction,
title = {{Interaction of sex and insulin resistance with cognitive impairment in community-dwelling middle-aged and older adults}},
author = {Jung Sook Kim and Byung Chul Chun and Joong-Yeon Lim},
journal = {Frontiers in aging neuroscience},
year = {2026},
month = oct,
doi = {10.3389/fnagi.2026.1889416},
url = {https://europepmc.org/article/PMC/PMC13719425},
note = {CC BY},
}
RIS
TY - JOUR
TI - Interaction of sex and insulin resistance with cognitive impairment in community-dwelling middle-aged and older adults
AU - Jung Sook Kim
AU - Byung Chul Chun
AU - Joong-Yeon Lim
PY - 2026
DA - 2026/10/16
JO - Frontiers in aging neuroscience
DO - 10.3389/fnagi.2026.1889416
UR - https://europepmc.org/article/PMC/PMC13719425
AB - Introduction: Cognitive impairment is a major global health challenge. However, whether sex and age interactively varies the association between insulin resistance and cognitive impairment remains unclear. This cross-sectional study aimed to evaluate the association between insulin resistance and cognitive impairment and identify sex- and age-specific interactions in community-dwelling adults. Methods: The study involved 3,898 participants (aged 54–86 years) from the Ansan-Ansung cohort of the Korean Genome and Epidemiology Study (2017–2018). Insulin resistance was assessed via Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), with participants dichotomized by the median (1.97). Cognitive impairment was defined as a score of ≤23 on the Korean Mini-Mental State Examination score. Multivariable logistic regression was applied to examine the interaction and stratified effects of sex and age (≥65 vs. <65 years) on the insulin resistance–cognitive impairment association. Results: Among 3,898 participants (mean age 66.6 years; 55.5% women), 635 (16.3%) had cognitive impairment. A significant interaction was observed between sex and HOMA-IR (p = 0.04), whereas the interaction for age was not significant (p = 0.17). In stratified analyses, higher HOMA-IR was significantly associated with cognitive impairment exclusively in women aged ≥65 years (OR 1.37; 95% CI 1.02–1.84; p = 0.04). Conclusion: Higher insulin resistance is a significant modifiable factor for cognitive impairment, specifically in women aged ≥65 years. These exploratory findings suggest potential sex-related differences in the metabolic-cognitive association, underscoring the importance of sex-specific metabolic management starting from midlife to help preserve cognitive health in later life.
SN - 1663-4365
ER -