ORIGINAL RESEARCH article
Front. Public Health
Sec. Aging and Public Health
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1607228
This article is part of the Research TopicAssociation of Diabetes Mellitus with Cognitive Impairment and Neurological Disorders Vol. 2View all 3 articles
Associations between the METS-IR index and cognitive function in community-dwelling Chinese middle-aged and elderly individuals: a cross-sectional study
Provisionally accepted
- Guilin Medical University, Guilin, China
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The relationship between insulin resistance and cognitive function has long been a subject of interest, but the association between the metabolic syndrome-insulin resistance (METS-IR) index and cognitive impairment remains unclear.We utilized data from the 2015 China Health and Retirement Longitudinal Study (CHARLS) national survey, which, after screening, included a final sample of 12,307 participants.Cognitive function was assessed through face-to-face interviews via the MMSE scale. Multivariate logistic regression was used to evaluate the correlation between the METS-IR index and cognitive impairment. Using regression analysis results from fully adjusted models, we subsequently explored the nonlinear relationship between the METS-IR index and cognitive impairment via smooth curve fitting with constrained cubic splines and sought potential inflection points. Additionally, we executed a battery of sensitivity and subgroup analyses to validate the robustness of our findings.The study included 12,307 participants, of whom 49.02% were aged 45-60 years and 52.89% were female. The results revealed that for each unit increase in the METS-IR index, the risk of cognitive impairment increased by 1.4% (OR=1.014, 95% CI: 1.004-1.023; p<0.01). When the METS-IR index was used as a categorical variable, compared with Q1, the odds of cognitive impairment increased by 17.1%, 38.7%, and 49.5% for each unit increase in the METS-IR index in the Q2, Q3, and Q4 groups, respectively. In addition, a nonlinear pattern was found in the analysis, and the endpoint of the METS-IR index was determined to be 38.1. On the left side of the endpoint, a one-unit increase in the METS-IR index was associated with a 3.1% increase in the risk of cognitive impairment. On the right side of the endpoint, the risk of cognitive impairment increased by 1.0% for each unit increase in the METS-IR index (all p<0.05). Conclusions: This study highlighted the significant association between high METS-IR and the risk of cognitive impairment in Chinese middle-aged and elderly individuals. In addition, there was a specific nonlinear relationship between the METS-IR index and cognitive impairment (the inflection point was 38.1). Lowering the METS-IR index below 38.1 through lifestyle changes can significantly reduce the risk of cognitive impairment and may decrease the incidence of dementia.
Keywords: METS-IR, cognitive impairment, Middle-aged and elderly, Insulin Resistance, CHARLS
Received: 07 Apr 2025; Accepted: 10 Jul 2025.
Copyright: © 2025 Jiang, Ma, Feng, Tang, Chen, He and Pang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Weiyi Pang, Guilin Medical University, Guilin, China
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