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Background: Type 2 diabetes mellitus (DM2) is associated with cognitive impairment. Peripheral insulin resistance is known to be the major contributor to the progression of hyperglycemia and DM. However, the relationship between insulin resistance (IR) and the risk of cognitive decline in non-diabetic patients is not clear so far. Methods: We analyzed 18 Alzheimer disease (AD) patients, 19 mild cognitive impairment (MCI) patients, and 24 cognitively healthy controls without diabetes. We examined their demographic characteristics, current and past illness and Mini-Mental State Examination (MMSE). We also examined insulin resistance index (Homeostasis Model Assessment of Insulin Resistance, HOMA-IR) as an indicator of IR and a factor associated with cognitive decline. Results: Levels of HOMA-IR were significantly different among the 3 groups (p<0.05) and HOMA-IR levels detected in the AD group were higher than those in the MCI and control groups. They were negatively correlated with the MMSE (p<0.01) and significantly connected with the cognitive decline subjects (r=-0.351, p<0.01). Multiple regression analysis revealed that the level of HOMA-IR was independently associated with cognitive decline (p<0.05). Conclusions: HOMA-IR levels were related to cognitive decline and these results suggest that HOMA-IR may be an important risk factor of dementia.

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