Abstract: Objective To explore the relationship between insulin resistance index (HOMA-IR) and swallowing dysfunction in elderly patients with mild cognitive function impairment (CFI). 
Methods A total of 106 elderly patients with mild CFI were selected as the observation group, and 100 elderly physical examinees without CFI were selected as the control group. The fasting blood glucose (FBG), fasting serum insulin (FINS), glycosylated hemoglobin (HbA1c) and HOMA-IR were compared between the observation group and control group. The correlation between blood glucose index and Montreal cognitive assessment (MoCA) score was analyzed. The observation group was divided into two groups according to presence of swallowing dysfunction: swallowing dysfunction group and non-swallowing dysfunction group. The clinical data of the two groups were compared, and the influencing factors of swallowing dysfunction and the value of logistic regression equation in predicting swallowing dysfunction were analyzed. 
Results FBG, FINS, HbA1c and HOMA-IR in the observation group were significantly higher than those in the control group (P＜0.05). FBG, FINS, HbA1c and HOMA-IR were negatively correlated with MoCA scores (r=-0.311, -0.324, -0.308, -0.341, P＜0.05). In the observation group, swallowing dysfunction occurred in 22 patients (20.75%). The proportion of patients with dysphagia aged ≥ 70 years, diabetes, audiovisual impairment, tooth defect ≥ 6, and FINS, HOMA-IR was significantly higher than those of patients without dysphagia (P＜0.05). Logistic regression analysis showed that age, audiovisual impairment, tooth defect and HOMA-IR were the influencing factors of mild CFI with swallowing dysfunction in the elderly (P＜0.05). The area under the receiver operating characteristic (ROC) curve of the Logistic regression equation in predicting swallowing dysfunction was 0.834 (95%CI: 0.733-0.936), the sensitivity was 84.50%, and the specificity was 63.00%. 
Conclusion The level of HOMA-IR increases in the elderly with mild CFI, which is negatively correlated with MOCA score of patients, and is also an influencing factor of swallowing dysfunction in patients. 

Key words: cognitive dysfunction, dysphagia, insulin resistance