Fig. 2: Insulin resistance is recognized as a crucial factor in the pathogenesis of cognitive impairment.
From: Central cytometabolic functional vascular coupling in health and disease
Insulin resistance contributes significantly to vascular dysfunction and ANVU dysfunction, through impaired glucose metabolism, oxidative stress, and inflammation. This leads to microvascular rarefaction and vasodilator dysfunction, reducing cerebral perfusion and increasing microinfarcts, microbleeds, and BBB dysregulation. Additionally, insulin resistance promotes amyloid-β accumulation and tau hyperphosphorylation via disrupted insulin signaling, while hypertension further impairs perivascular and glymphatic clearance. Together, these mechanisms accelerate Alzheimer’s-associated pathology and cognitive impairment.
