INS and Cognitive impairment: Although this is a pilot trial, these findings could be relevant because cognitive impairment in OA is not well understood, and there are no effective interventions, and results support the need for future trials focused on GlyNAC to understand its impact on cognition as well as underlying mechanistic defects linked to cognition in terms of OxS, GSH deficiency, mitochondrial impairment, inflammation, insulin resistance, and endothelial function.