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Long-term fasting insulin variability and cognitive function: Insights from the CARDIA study.
Bo-Shui Huang1, Zuo-Yu Huang2, Yu-Hong Zeng3
1Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
The Journal of Prevention of Alzheimer'S Disease
|February 1, 2026
Summary
High long-term insulin variability is linked to worse cognitive function in midlife. This suggests insulin variability may serve as an early indicator of cognitive health decline.
Area of Science:
- Metabolic Health
- Neuroscience
- Longitudinal Studies
Background:
- Fasting insulin variability is a potential marker for metabolic dysregulation.
- Long-term implications of insulin variability on cognitive function are not well understood.
Purpose of the Study:
- To investigate the association between long-term fasting insulin variability and cognitive function.
- To determine if insulin variability predicts cognitive decline over time.
Main Methods:
- Analysis of CARDIA study data with multiple insulin measurements over 30 years.
- Assessment of intra-individual insulin variability using SD, CV, and ARV.
- Cognitive function evaluated using DSST, Stroop, and RAVLT, with results standardized to z-scores.
Main Results:
- Higher long-term insulin variability correlated with poorer global cognitive performance at 25 years.
- Associations remained significant after adjusting for covariates and concurrent/mean insulin levels.
- Insulin variability was linked to deficits in attention (DSST) and executive function (Stroop).
Conclusions:
- Increased long-term insulin variability is independently associated with diminished midlife cognitive performance.
- Insulin variability emerges as a potential biomarker for cognitive health risk.
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