Observational studyJournal of Alzheimer's disease : JAD2023
Insulin Homeostasis Mediates the Relationship Between Cardiorespiratory Fitness and Cognitive Speed in Aging Adults.
Observational study in Journal of Alzheimer's disease : JAD, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Inflammatory, metabolic, and vascular pathways linking cardiorespiratory fitness to cognition: Results from the IGNITE study.Brain, behavior, & immunity - health · 2026Article
- From Metabolism to Mind: The Cardio-Metabolic-Brain Axis and the Role of Insulin Resistance-A Review.Biomedicines · 2026Review
- Metabolic status and brain health: the relationship between the metabolic score for insulin resistance and cognitive function in older adults.European journal of medical research · 2025Article
- Insulin resistance, cognition, and functional brain network topology in older adults with obesity.Scientific reports · 2025Article
- Sex modifies the association between cardiorespiratory fitness and insulin resistance in adults at risk for Alzheimer's disease.Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme · 2025Observational
- The impact of estimated cardiorespiratory fitness on Alzheimer's disease biomarkers and their relationships with cognitive decline.Alzheimer's & dementia (New York, N. Y.)Article
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Authors and funding
9 authors.
Funding
Abstract
backgroundCardiorespiratory fitness (CRF) supports cognition, though it is unclear what mechanisms underly this relationship. Insulin resistance adversely affects cognition but can be reduced with habitual exercise.
objectiveWe investigated whether insulin resistance statistically mediates the relationship between CRF and cognition.
methodsIn our observational study, we included n = 1,131 cognitively unimpaired, nondiabetic older adults from a cohort characterized by elevated Alzheimer's disease (AD) risk. We estimated CRF (eCRF) using a validated equation that takes age, sex, body mass index, resting heart rate, and habitual physical activity as inputs. The Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) quantified insulin resistance. Standardized cognitive factor scores for cognitive speed/flexibility, working memory, verbal learning/memory, and immediate memory were calculated from a battery of neuropsychological tests. Linear regression models and bootstrapped estimates of indirect effects were used to determine whether HOMA-IR mediated significant relationships between eCRF and cognition.
resultseCRF was positively associated with cognitive speed/flexibility (p = 0.034). When controlling for HOMA-IR, eCRF was no longer associated with cognitive speed/flexibility (p = 0.383). HOMA-IR had a significant indirect effect on the eCRF-cognition relationship (B = 0.025, CI = [0.003,0.051]). eCRF was not associated with working memory (p = 0.236), immediate memory (p = 0.345), or verbal learning/memory (p = 0.650).
conclusionAmong older adults at risk for AD, peripheral insulin resistance mediates the relationship between CRF and cognitive speed.
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