AIMS/HYPOTHESIS: Type 2 @entity6 is an independent risk factor for @entity73 . @entity2690 resistance occurring during midlife may increase the risk of @entity73 later in life. We hypothesised that @entity2690 resistance is associated with poorer cognitive performance and that sex and @entity2204 *E4 might modulate this association. METHODS: The association of @entity2690 resistance and @entity2204 *E4 genotype on cognitive function was evaluated in a nationwide Finnish population-based study (n   =   5,935, mean age 52.5  years, range 30-97  years). HOMA-IR was used to measure @entity2690 resistance. Cognitive function was tested by word-list learning, word-list delayed-recall, categorical verbal fluency and simple and visual-choice reaction-time tests. Linear regression analysis was used to determine the association between HOMA-IR and the results of the cognitive tests. RESULTS: Higher HOMA-IR was associated with poorer verbal fluency in @entity1 (p   <   0.0001) but not in @entity1 (p   =   0.56). Higher HOMA-IR was also associated with poorer verbal fluency in @entity2204 *E4 -negative individuals (p   =   0.0003), but not in @entity2204 *E4 carriers (p   =   0.28). Furthermore, higher HOMA-IR was associated with a slower simple reaction time in the whole study group (p   =   0.02). CONCLUSIONS/INTERPRETATION: To our knowledge, this is the first comprehensive, population-based study, including both young and middle-aged adults, to report that female sex impacts the association of HOMA-IR with verbal fluency. Our study was cross-sectional, so causal effects of HOMA-IR on cognition could not be evaluated. However, our results suggest that HOMA-IR could be an early marker for an increased risk of @entity73 in @entity1 .

@entity2690 resistance is associated with poorer verbal fluency performance in XXXX .

@entity1 :: ('9606', 'Species') :: ['women', 'men'] @entity6 :: ('MESH:D003920', 'Disease') :: ['diabetes'] @entity2204 :: ('348', 'Gene') :: ['APOE'] @entity73 :: ('MESH:D003072', 'Disease') :: ['cognitive decline'] @entity2690 :: ('3630', 'Gene') :: ['Insulin', 'insulin']
@entity1 :: (9606,Species) :: ['women']
