Higher TyG index was associated with a significantly higher risk of cognitive impairment in elderly patients with T2DM when adjusting for age, sex and education (OR: 4.709; 95% CI: 2.515 to 8.817; P for trend <0.001) and after further adjustment for hypertension, history of stroke, SBP, HbA1c, HDL-C, insulin or metformin usage and serum tHcy (OR: 3.298; 95% CI: 1.685 to 6.452; P for trend <0.001) in the highest tertile of TyG index levels compared with the lowest (Table 4). Here, INS is linked to Cognitive impairment.