Executive Function In Women Research Articles

Gender differences in the association between education and late-life cognitive function in the LifeAfter90 Study: A multiethnic cohort of the oldest-old.

Few studies have examined the relationship between education and cognition among the oldest-old. Cognitive assessments were conducted biannually for 803 participants (62.6% women) of LifeAfter90, a longitudinal study of individuals ≥90 years old. Gender differences in associations between education (<high school, high school, some college, and ≥ college) and cognition (verbal episodic memory, semantic memory, and executive function) were examined at baseline and longitudinally using linear mixed models. Higher education levels were associated with better cognitive performance at baseline for both men and women. College completion was more strongly associated with better baseline executive function among women. Education-cognition associations for baseline verbal episodic memory and baseline semantic memory did not differ by gender. Education was not associated with a decline in any domain-specific cognitive scores, regardless of gender. Education is associated with cognitive function among the oldest-old and varies by gender and cognitive domain at baseline but not over time. In the oldest-old, higher education was associated with better cognitive function. College completion was more strongly associated with executive function in women. Education was not associated with cognitive decline after age 90 regardless of gender. Improving education could decrease gaps in cognitive level among older individuals.

Long-term effects of an egg-protein hydrolysate on cognitive performance and brain vascular function: a double-blind randomized controlled trial in adults with elevated subjective cognitive failures

PurposeShort-term intake of the egg-protein hydrolysate Newtricious (NWT)-03 improved executive function, but underlying mechanisms and long-term effects, including other cognitive domains, are unknown.MethodsA 36-week randomized controlled trial involving 44 overweight/obese individuals experiencing elevated Subjective Cognitive Failures (SCF; aged 60–75 years) assessed the impact of daily consumption of 5.7 g of NWT-03 or placebo powders on cognitive performance (psychomotor speed, executive function, memory) and Cerebral Blood Flow (CBF), a marker of brain vascular function. Cognitive performance was evaluated using a neurophysiological test battery (CANTAB) and CBF was measured using magnetic resonance imaging perfusion method Arterial Spin Labeling (ASL). Serum samples were collected to determine brain-derived neurotrophic factor (BDNF) concentrations.ResultsAnthropometrics, and energy and nutrient intakes remained stable throughout the trial. NWT-03 was well tolerated, and compliance was excellent (median: 99%; range: 87–103%). No overall intervention effects were observed on cognitive performance or CBF, but post-hoc analyses revealed significant improvements on executive function in women, but not men. Specifically, a reduction of 74 ms in reaction latency on the multitasking task (95% CI: −134 to −15; p = 0.02), a reduction of 9 between errors (95%CI: −14 to −3; p < 0.001), and a reduction of 9 total errors (95%CI: −15 to −3; p < 0.001) on the spatial working memory task were found in women. No intervention effects were observed on serum BDNF concentrations (p = 0.31).ConclusionLong-term consumption of NWT-03 improved multitasking abilities and working memory in women with elevated SCF. Brain vascular function remained unaffected. Sex differences in executive function require additional clarification.

Polypharmacy, drug-drug interactions, anticholinergic burden and cognitive outcomes: a snapshot from a community-dwelling sample of older men and women in northern Italy

Polypharmacy (PP) use is very common in older people and may lead to drug-drug interactions (DDIs) and anticholinergic burden (ACB) that may affect cognitive function. We aimed to determine the occurrence of PP, potential DDIs and ACB and their role in cognitive outcomes in an older population. Cross-sectional data from 636 community-dwelling adults (73.2 ± 6.0 SD, 58.6% women) participating in the NutBrain study (2019–2023) were analyzed. Participants were asked about their medication use, and data on potential DDIs and ACB were extracted. The associations of PP (≥ 5 drugs/day), potential DDIs, and ACB with mild cognitive impairment (MCI) and specific cognitive domains were assessed using logistic regression adjusted for confounders. Sex-stratified analysis was performed. Overall, 27.2% of the participants were exposed to PP, 42.3% to potential DDIs and 19% to cumulative ACB. Women were less exposed to PP and more exposed to ACB than men. In multivariate analysis, the odds of having MCI (24%) were three times higher in those with severe ACB (≥ 3) (OR 3.34, 95%CI 1.35–8.25). ACB was positively associated with poor executive function (OR 4.45, 95%CI 1.72–11.49) and specifically with the Frontal Assessment Battery and neuropsychological tests of phonological and semantic fluency. In sex-stratified analysis, ACB was statistically significantly associated with MCI and executive function in women and with memory in men. PP, potential DDIs and anticholinergics use are very common in community-dwelling older people. ACB exposure is associated with MCI, particularly with poor executive function. Clinicians are encouraged to be vigilant when prescribing anticholinergics.Trial registration: Trial registration number NCT04461951, date of registration July 7, 2020 (retrospectively registered, ClinicalTrials.gov).

SEX DIFFERENCES IN THE ROLE OF SLEEP ON EXECUTIVE FUNCTION IN OLDER ADULTS

Abstract Advancing age is associated with a decline in sleep quality and cognitive performance. Previous work has shown that women report a higher number of sleep complaints, possibly due to hormonal and physiologic developmental changes across the lifespan. However, whether the effects of sleep quality on cognitive performance differ between sexes in older populations remains unclear. To address this gap, we analyzed data from 117 cognitively normal participants (44 men and 73 women) aged 60 and older (M = 74.82, SD = 6.52) to compare the effects of objectively measured sleep on executive function. Total sleep time was recorded with the GT9X Link Actigraph worn for seven consecutive days. The composite score of executive function was derived from a confirmatory factor analysis consisting of four separate tests (Verbal Fluency, Trail Making Test Part B, Digit Symbol Substitution Test, and Stroop Interference). We used hierarchical multiple regression to investigate sex differences in the effects of total sleep time on executive function. A quadratic model of total sleep time was a significant predictor of executive function in women (β = -.251, p = .034), but not in men adjusting for age and education. Longer sleep duration predicted improved executive function, but the performance decreased with oversleeping. These findings imply that interventions aimed at optimizing sleep duration may be beneficial for executive function in older women. Further research is necessary to identify sex-specific sleep requirements, which can inform the development of personalized interventions for older adults.

The impact of threat of shock-induced anxiety on alerting, orienting, and executive function in women: an ERP study.

The present study used a combination of the Threat-of-Shock paradigm and the Attention Network Test (ANT) to investigate how induced anxiety affects alerting, orienting, and executive control and whether individual differences in threat sensitivity moderate these effects. Forty-two female subjects completed the ANT task in alternation under shock-threat and no-shock ("safe") conditions while event-related potentials (ERPs) were recorded. The results showed that anxiety induced by the threat of shock had a significant impact on alerting and executive control functions at the neural level. Specifically, alerting-related N1 and stimulus-preceding negativity (SPN) differences between double cue and no cue conditions were greater in the threat versus safe state, suggesting that the induced anxiety promoted the early perception of cues and preparation for the target. Moreover, executive control-related P3 and sustained potential (SP) differences between incongruent and congruent trials were greater in the threat versus safe state, indicating that the induced anxiety might improve the attentional allocation efficiency and stimulate subjects to recruit more cognitive resources to resolve conflicts. However, orienting-related ERPs were not affected by the threat of shock, but the threat of shock promoted the processing efficiency of spatial-cue at the behavioral level. Analysis of individual differences revealed that trait anxiety moderated the attentional allocation efficiency when performing executive control related tasks in the threat versus safe state. Our findings demonstrate the adaptive significance of the threat of shock-induced anxiety in that being in an anxious state can enhance individuals' alerting, orienting, and executive functions.

Functional social isolation mediates the association between depression and executive function in older women: findings from the Canadian Longitudinal Study on Aging Comprehensive cohort

ABSTRACT Depression and social isolation increase risk for executive function declines and are among the top five modifiable risk factors for dementia. However, the interrelationships between depression, social isolation and executive function are not well established. Further evidence is needed to inform strategies to promote executive function and independence in older age. We examined whether social isolation mediated the association between depression and executive function in community-dwelling middle-aged and older adults and whether this association was modified by age and sex. Adults aged 45 to 85 years from the Canadian Longitudinal Study on Aging (CLSA) Comprehensive cohort were followed over three years (complete case analysis, n = 14,133). Baseline depressive symptoms, a history of clinical depression, and functional social isolation (perceived lack of social support) were self-reported. Executive function at follow-up was a composite measure of five cognitive tests. Conditional process analysis assessed the mediating effects of functional social isolation across age group and sex, adjusted for sociodemographic and health covariates. Functional social isolation significantly mediated the association of depressive symptoms (proportion mediated [P M ] = 8.0%) or clinical depression (P M = 17.5%) with executive function only among women aged 75+ years. Functional social isolation explains a proportion of the total effect of depressive symptoms or clinical depression on executive function in women aged 75 and older. Although reverse causation cannot be ruled out, our findings suggest that interventions that reduce functional social isolation or depression in older women may promote executive function.

Exercise and Gotu Kola Extract to Ameliorate Tumor Necrosis Factor - Alpha, Quality of Life, and Executive Function in Cognitive Impairment Women

Increasing tumor necrosis factor-alpha (TNF-alpha) and decreasing quality of life (QoL) are associated with cognitive deterioration. Exercise and Gotu kola (Centella Asiatica) can improve memory and antiinflammation, but their combination has not yet been revealed. This study aimed to see how exercise and Gotu kola extract affected TNF-alpha, quality of life, and executive functions in women with cognitive impairment. This study used an experimental design with a control group with a 12-week pre and post-test in women with cognitive impairment. The Montreal Cognitive Assessment (MoCA) was used to screen for cognitive impairment. The participants in the study were 64 women with a mean age of 53.3 (4.8) years. The subjects were divided into four groups: Gotu kola/GK extract capsule (1x500 mg/day), exercises (2x75 minutes per week), a GK-exercise combination, and the control group. The WHO-QoL questionnaire was used to assess the quality of life. The Trail Making Test-B (TMT-B) was used to assess executive functions. The study found that Gotu kola might increase QoL in the physical domain (p=0.028) and environmental domain (p=0.016). Exercise and a GK-exercise combination could improve QoL: physical, psychological, social, and environmental domain (p<0.05). According to the Mann-Whitney test, the GK-exercise combination was the most helpful in enhancing TNF-alpha (Δ=-10.5; p=0.003), MoCA (∆= 4.6; p=<0.001), and TMT-B (Δ=-21.4; p=0.023). Discussion: Physical activity is one of the factors that can play a role in cognitive function through several mechanisms. To conclude, exercise, Gotu Kola, and their combination can effectively decrease inflammation and increase the quality of life and cognitive function in women with cognitive impairment. This study expected that exercise and Gotu Kola could be priority interventions in treating cognitive impairment.

Association between risk of obstructive sleep apnea, inflammation and cognition after 45 years old in the Canadian Longitudinal Study on Aging

BackgroundThe association between obstructive sleep apnea and cognitive functioning is not yet fully understood and could be influenced by factors such as sex, age and systemic inflammation. We determined the sex- and age-specific association between obstructive sleep apnea risk and cognitive performance, and the influence of systemic inflammation on this association. MethodsWe included 25,899 participants from the Canadian Longitudinal Study of Aging comprehensive cohort, aged 45–85 years (51% women). We conducted sex- and age-specific (45–59; 60–69; ≥70) general linear models between obstructive sleep apnea risk and cognitive scores, and tested the moderating and mediating effects of high-sensitivity C-reactive protein levels. Obstructive sleep apnea risk was estimated by combining the STOP and whole-body fat percentage. Cognitive tests assessed episodic verbal memory, executive functions and psychomotor speed. Levels of high-sensitivity C-reactive protein were obtained through blood samples. ResultsHigher obstructive sleep apnea risk was associated with poorer episodic memory in women aged 45–59 years, and poorer executive function (p < 0.05 on multiple tests) in women aged 45–59 and 60–69 years. No such association was found in men. High-sensitivity C-reactive protein levels mediated some associations between obstructive sleep apnea risk and executive function in women and men aged <70 years. ConclusionsBeing at high-risk for obstructive sleep apnea is associated with poorer cognition in women aged <70 years. These associations were partly mediated by systemic inflammation. These results underscore the importance of obstructive sleep apnea diagnosis, treatment and appropriate follow-up, particularly in middle-aged women who might already show signs of early cognitive impairments.

Breaking up prolonged sitting with a 6 min walk improves executive function in women and men esports players: a randomised trial

ObjectiveThe effect of prolonged sitting on executive function and performance in competitive esports players are unknown. This study aimed to evaluate executive function following a 6 min bout of walking...

Unaffected Memory and Inhibitory Functioning Several Weeks Postpartum in Women with Pregnancy Complicated by Preeclampsia.

Several studies reported impaired cognitive functioning after pregnancy complicated by preeclampsia. The present study examined cognitive and executive functioning in women with preeclampsia at a time at which immediate effects of gestation have resolved, brain damage due to other risk factors have not yet manifested, and impairments may thus primarily occur as a result of the huge stress induced by the potentially life threatening condition. Verbal learning/memory (California Verbal Learning Test) and inhibitory functioning (Mittenecker Pointing Test) of 35 women with preeclampsia and 38 women with uncomplicated pregnancy were followed over five measurement time points during the period from 16 to 48 weeks postpartum. A further control group comprised 40 women with no history of recent pregnancy. The groups did not differ in their verbal learning/memory performance. Higher levels of currently experienced everyday-life stress were associated with poorer inhibitory control/greater stereotypy in responding, but this effect was not directly connected with pregnancy complications. Taken together, the findings do not indicate rapid-onset cognitive impairment after preeclampsia, brought about by its extremely stressful nature or other factors that take effect during gestation. Deficits observed in later life may develop on a long-term basis through late-diagnosed hypertension and unfavorable lifestyle factors. The large time window in which exaggerated cognitive decline can be prevented or mitigated should be utilized for the control of risk factors and interventions to improve lifestyle where appropriate.

Combined aerobic and resistance training improves physical and executive functions in women with systemic lupus erythematosus.

Exercise is considered as an adjuvant therapeutic modality to alleviate symptoms of several rheumatic diseases. However, data regarding the benefits of exercise to patients with systemic lupus erythematosus (SLE) are relatively scant. This study aimed to assess the effects of regular, moderate-intensity, aerobic exercise combined with resistance training on women with SLE who had no regular exercise. Patients were recruited and allocated into either the exercise or control group by their willingness. Patients in the exercise group (n = 12) underwent 12 weeks of combined exercise (five days per week), whereas those in the control group (n = 11) maintained their usual lifestyle. At baseline, there were no between-group differences in body composition, disease activity, two-kilometer walking test, and executive function test. After the combined exercise intervention for 12 weeks, significant improvements of both fitness index and reaction time to the stimuli in the go/no-go test were observed in the exercise group, but not in the control group. The disease activities in both study groups did not change significantly at the end of the study period. Our results suggest that regular moderate-intensity aerobic exercise combined with resistance training improves the physical and executive functions of SLE patients without exacerbating disease activity.

A process approach to verbal memory assessment: Exploratory evidence of inefficient learning in women remitted from anorexia nervosa

ABSTRACTIntroduction: Anorexia nervosa (AN) is associated with deficits in set-shifting and cognitive flexibility, yet less is known about the persistence of these deficits after recovery and how they might contribute to reported difficulties organizing and learning new information. To address this question, the current study applied a process-focused approach, that accounts for errors and strategies by which a score is achieved, to investigate the relationship between verbal memory and executive function in women remitted from AN.Method: Twenty-six women remitted from anorexia nervosa (RAN) and 25 control women (CW) aged 19–45 completed the California Verbal Learning Test, Second edition (CVLT-II) and the Wisconsin Card Sorting Test (WCST). Groups were compared on overall achievement scores, and on repetition, intrusion, and perseverative errors on both tests. Associations between learning and memory performance and WCST errors were also examined.Results: RAN and CW groups did not differ on overall CVLT-II learning and memory performance or errors on the WCST, though the RAN group trended towards greater WCST non-perseverative and total errors. On the CVLT-II, the RAN group made significantly more repetition errors than CW (p = 0.010), and within-trial perseveration (WTP) errors (p = 0.044). For the CW group, CVLT-II learning and memory performance were negatively associated with errors on the WCST, whereas among RAN, primarily delayed memory was negatively correlated with WCST errors. Notably, for RAN, greater WCST perseverative responses were correlated with greater CVLT-II repetition and WTP errors, showing the convergence of perseverative responding across tasks.Conclusions: Despite similar overall learning and memory performance, difficulties with executive control seem to persist even after symptom remission in patients with AN. Results indicate an inefficient learning process in the cognitive phenotype of AN and support the use of process approaches to refine neuropsychological assessment of AN by accounting for strategy use.

Effect of Cognitive Training on Promotion of Executive Functions in Women with Postpartum Depression in Bushehr City

Effect of Cognitive Training on Promotion of Executive Functions in Women with Postpartum Depression in Bushehr City

Food addiction and impaired executive functions in women with obesity.

Individuals with obesity (OB) often report suffering from addiction-like symptoms. As in addictions, deficits in executive function domains, such as decision-making and sustained attention, are found in OB. No study to date has examined the associations between food addiction, OB, and neuropsychological performance. Thirty-three adult women with OB and 36 healthy weight controls completed the Yale Food Addiction Scale Version 2.0, a validated instrument used to assess food-related addictive behaviours. Additionally, participants completed computerized versions of the Iowa Gambling Task (IGT) and Conners' Continuous Performance Test, second edition (CPT-II) to examine decision-making and attentional control, respectively. Food addiction criteria were met in 24.2% of the participants with OB and in 2.8% of the control group. In the OB group, food addiction severity levels were negatively correlated with overall scores on the IGT. Participants with OB meeting criteria for food addiction committed more omissions and perseveration errors on the CPT-II compared with those without food addiction. Our results point to an association between food addiction severity levels and impairments in decision-making and attentional capacity in individuals with OB. Given the heterogeneity found in OB, it stands to reason that this subset of patients with food addiction could potentially benefit from interventions targeting neuropsychological deficits.

Trajectories of depressive and anxiety symptoms in older adults: a 6-year prospective cohort study.

Depressive and anxiety symptoms are common in older adults, significantly affect quality of life, and are risk factors for Alzheimer's disease. We sought to identify the determinants of predominant trajectories of depressive and anxiety symptoms in cognitively normal older adults. Four hundred twenty-three older adults recruited from the general community underwent Aβ positron emission tomography imaging, apolipoprotein and brain-derived neurotrophic factor genotyping, and cognitive testing at baseline and had follow-up assessments. All participants were cognitively normal and free of clinical depression at baseline. Latent growth mixture modeling was used to identify predominant trajectories of subthreshold depressive and anxiety symptoms over 6years. Binary logistic regression analysis was used to identify baseline predictors of symptomatic depressive and anxiety trajectories. Latent growth mixture modeling revealed two predominant trajectories of depressive and anxiety symptoms: a chronically elevated trajectory and a low, stable symptom trajectory, with almost one in five participants falling into the elevated trajectory groups. Male sex (relative risk ratio (RRR)=3.23), lower attentional function (RRR=1.90), and carriage of the brain-derived neurotrophic factor Val66Met allele in women (RRR=2.70) were associated with increased risk for chronically elevated depressive symptom trajectory. Carriage of the apolipoprotein epsilon 4 allele (RRR=1.92) and lower executive function in women (RRR=1.74) were associated with chronically elevated anxiety symptom trajectory. Our results indicate distinct and sex-specific risk factors linked to depressive and anxiety trajectories, which may help inform risk stratification and management of these symptoms in older adults at risk for Alzheimer's disease. Copyright © 2017 John Wiley & Sons, Ltd.

Lisdexamfetamine Effects on Executive Activation and Neurochemistry in Menopausal Women with Executive Function Difficulties.

Many women with no history of executive dysfunction report difficulties in this domain during the menopause transition. Lisdexamfetamine (LDX) has been suggested to be a safe and effective treatment option for these women. However, the mechanism by which LDX improves executive functioning in these women is not known. Here we investigated the effects of LDX on brain activation and neurochemistry, hypothesizing that LDX would be associated with increased activation and decreased glutamate in executive regions. Fourteen women underwent multimodal neuroimaging at 7T at three time points in this baseline-corrected, double-blind, placebo-controlled, crossover study. Effects of LDX on symptom severity, blood-oxygen-level-dependent (BOLD) signal, and dorsolateral prefrontal cortex (DLPFC) glutamate+glutamine (Glx) were measured using a clinician-administered questionnaire, fMRI during performance of a fractal n-back task, and 1H-MRS, respectively. The effect of treatment (LDX minus baseline vs placebo minus baseline) on these behavioral and neural markers of executive function was examined using repeated measures mixed effects models. LDX treatment was associated with decreased symptom severity, increased activation in the insula and DLPFC, and decreased DLPFC Glx. In addition, the magnitude of LDX-induced improvement in symptom severity predicted both direction and magnitude of LDX-induced change in insular and DLPFC activation. Moreover, symptom severity was positively correlated with Glx concentration in the left DLPFC at baseline. These findings provide novel evidence that the neural mechanisms by which LDX acts to improve self-reported executive functioning in healthy menopausal women with midlife onset of executive difficulties include modulation of insular and DLPFC recruitment as well as decrease in DLPFC Glx concentration.

Self-focused attention in anorexia nervosa.

The clinical presentation of anorexia nervosa (AN) is characterized by preoccupation with body experience, intrusive concerns regarding shape, and pathological fears of weight gain. These symptoms are suggestive of unrelenting self-focused attention. No research to date has characterized self-focused attention (SFA) in AN nor examined neurocognitive features that may facilitate an excessive, rigid, or sustained focus on one's appearance. This study examined SFA, body image disturbance, and executive functioning in women with current anorexia nervosa (AN-C; n = 24), a history of AN who were weight-restored at the time of the study (WR; n = 19), and healthy controls (n = 24). Private and public SFA were highest among WR and lowest among AN-C. Shape concerns were negatively correlated with SFA, especially among AN-C, after controlling for depression and social anxiety symptoms. Lower levels of SFA among AN-C were unexpected and suggest the acute state of AN may lessen pathological self-focus, negatively reinforcing symptoms. In addition, body image concerns may distract from general SFA. Deficits in executive attention may explain these findings, as each one unit increase in perseverative errors among AN-C participants was associated with an almost one-half unit decrease in public SFA.

The sorting test of the D‐KEFS in current and weight restored anorexia nervosa patients

Efforts have been made to characterize executive functions (EF) in anorexia nervosa (AN) both in the acute stage of the illness and after weight gain, yet many questions remain. The question of verbal versus visuo-perceptual stimuli in this regard has not been adequately addressed. The aim of this study is to further examine EF in women with past and present AN and to compare their performances in verbal and visual modalities with women who have never suffered from an eating disorder. Thirty-five underweight AN patients, 33 weight-restored patients symptom-free for at least 2 years, and 48 healthy female controls completed the Delis-Kaplan Executive Function System Sorting Test, so as to evaluate their EF. No differences were observed between the scores of women with current and past AN. Both groups scored lower than controls on most test variables. However, while in the visuo-perceptual domain the performance of the AN groups was worse than that of controls, in the verbal domain they performed similarly to them. Women with a past or present diagnosis of AN show difficulties in visuo-perceptual EF, whereas verbal EF seem to be preserved. There may be a dissociation between verbal and visuo-perceptual EF that persists after weight restoration.

Executive function in eating disorders: The role of state anxiety

We examined the influence of depression and anxiety on executive function in individuals with a DSM-IV diagnosis of anorexia nervosa-restricting type, anorexia nervosa-binge-eating/purging type, bulimia nervosa, or eating disorder not otherwise specified. We assessed 106 women after their inpatient treatment in an eating disorders program. All participants were nutritionally stable at the time of testing. Thirty percent of the total sample showed impaired performance on one or more tests of executive function. No differences in executive function were observed among diagnostic groups. Anxiety scores accounted for significant variance in performance for all groups. Executive function deficits were found in a minority of our sample, with significant variance in performance accounted for by self-reported anxiety. State anxiety appears to contribute to diminished executive function in women with eating disorders.

Insulin-resistance and metabolic syndrome are related to executive function in women in a large family-based study

While type 2 diabetes is well-known to be associated with poorer cognitive performance, few studies have reported on the association of metabolic syndrome (MetS) and contributing factors, such as insulin-resistance (HOMA-IR), low adiponectin-, and high C-reactive protein (CRP)- levels. We studied whether these factors are related to cognitive function and which of the MetS components are independently associated. The study was embedded in an ongoing family-based cohort study in a Dutch population. All participants underwent physical examinations, biomedical measurements, and neuropsychological testing. Linear regression models were used to determine the association between MetS, HOMA-IR, adiponectin levels, CRP, and cognitive test scores. Cross-sectional analyses were performed in 1,898 subjects (mean age 48 years, 43% men). People with MetS had significantly higher HOMA-IR scores, lower adiponectin levels, and higher CRP levels. MetS and high HOMA-IR were associated with poorer executive function in women (P = 0.03 and P = 0.009). MetS and HOMA-IR are associated with poorer executive function in women.