Association of insulin resistance with visual decline in older individuals without diabetes: a cross-sectional mediation analysis.

logMAR and HOMA-R were significantly correlated in women without diabetes after adjustment for covariates.

• β = 0.166, P = 0.0002 in multiple regression analysis
• Association was found in women but not reported as significant in men
• Visual acuity assessed using logarithmic minimum angle of resolution (logMAR); insulin resistance assessed using homeostasis model assessment ratio (HOMA-R)
• Analysis adjusted for covariates

Body fat mass significantly mediated the relationship between logMAR and HOMA-R in women.

• Proportion mediated: 0.567 (95% CI: 0.058–0.938)
• Assessed via causal mediation analysis with body composition as a mediating factor
• The confidence interval excludes zero, indicating statistical significance

Body fat percentage significantly mediated the relationship between logMAR and HOMA-R in women.

• Proportion mediated: 0.685 (95% CI: 0.250–1.027)
• Assessed via causal mediation analysis
• Body fat percentage explained a larger proportion of the mediated effect than body fat mass

The study enrolled 797 older participants without diabetes from the Kyotango Longevity Cohort Study.

• All participants were aged 65 years and above
• Mean age was 74.8 ± 6.6 years in men and 73.4 ± 5.6 years in women
• The study was a cross-sectional analysis using data from a prospective cohort
• Study protocol approved by the Ethics Committee of the Kyoto Prefectural University of Medicine (ERB-C-885)

The association between visual impairment and insulin resistance was examined using Spearman's rank correlation coefficient and multiple regression analysis.

• Visual acuity measured as logMAR; insulin resistance measured as HOMA-R
• Causal mediation analysis was performed with body composition as a mediating factor
• Both body fat mass and body fat percentage were evaluated as potential mediators