Novel anthropometric indices and cognitive function among iranian older adults: Bushehr Elderly Health (BEH) program

BACKGROUND: This cross-sectional study investigated novel anthropometric indices including the triglyceride-glucose (TyG) index, visceral adiposity index (VAI), and lipid accumulation product (LAP), which have been proposed as simple markers of insulin resistance. A factor contributing to cognitive impairment through mechanisms such as endothelial dysfunction, inflammation, and neuronal injury. Due to these Insulin resistance-related pathways, such indices may help identify older adults at higher risk of cognitive impairment. This study aimed to investigate the associations between TyG, VAI, and LAP and cognitive function in Iranian older adults using data from the Bushehr Elderly Health (BEH) program. METHODS: This cross-sectional analysis used data from 2,426 participants aged ≥60 in the Bushehr Elderly Health program. Cognitive function was assessed using the functional assessment staging test (FAST), Mini-Cog, and category fluency test (CFT) questionnaires. Anthropometric indices (TyG, VAI, LAP) were calculated from clinical and laboratory measurements. Logistic regression, stratified by sex a priori and adjusted for demographic, lifestyle, and clinical confounders selected through backward stepwise regression, was used to examine associations with cognitive impairment. RESULTS: Among participants (mean age: 65.34 ± 6.40 years, 52% female), cognitive impairment was identified in 63.9%. In males, higher VAI was associated with impairment in the FAST test [Odds ratio (OR): 1.601, 95% CI: 1.164-2.203; P = 0.004)], while in females, VAI in the second quartile was linked to lower odds of impairment (OR = 0.583, 95% CI: 0.341-0.997, p = 0.049). No consistent associations were observed for TyG or LAP. CONCLUSION: Although some sex- and test-specific associations were observed, particularly with VAI, these findings highlight the complex and multifactorial association between metabolic health and cognitive function. This implies that factors beyond insulin resistance may contribute. Further longitudinal research is needed to clarify these relationships.