300 Section - Irisin as a biomarker of cognitive resilience: a 6-month prospective study in a cohort of older adults

Wednesday, May 20, 2026

6:00 PM - 7:30 PM PT

Presenting Author/Autor expositor(s)

FF

Francesco Paolo Fabrazzo, MD

Resident in in Physical and Rehabilitation Medicine
Università degli Studi della Campania "Luigi Vanvitelli"
Napoli, Campania, Italy

Co-Author/Coautor(s)

MA

Mariangela Airoma, MD

Medical Doctor, Specialist in Physical and Rehabilitation Medicine, Doctoral Student
Università degli Studi della Campania Luigi Vanvitelli
Portici, Campania, Italy
AS

Angela Scala, MD

Resident
Università degli Studi della Campania "Luigi Vanvitelli"
Marzano di Nola, Campania, Italy
SL

Sara Liguori, MD

Assistant Professor in Physical and Rehabilitation Medicine
Università degli Studi della Campania "Luigi Vanvitelli"
Napoli, Campania, Italy
MP

Marco Paoletta, MD

Assistant Professor in Physical and Rehabilitation Medicine
Università degli Studi della Campania "Luigi Vanvitelli"
Napoli, Campania, Italy
GI

Giovanni Iolascon, MD

Full Professor in Physical and Rehabilitation Medicine
Università degli Studi della Campania "Luigi Vanvitelli"
Napoli, Campania, Italy
FG

Francesca Gimigliano, MD

Full Professor in Physical and Rehabilitation Medicine
Università degli Studi della Campania "Luigi Vanvitelli"
Napoli, Campania, Italy
Antimo Moretti, MD (he/him/his)

Associate Professor in in Physical and Rehabilitation Medicine
Università degli Studi della Campania "Luigi Vanvitelli"
Caserta, Campania, Italy

Objectives : Myokines are proteins released by skeletal muscle during contraction, exerting paracrine/autocrine effects. Some have anabolic properties; others mediate systemic exercise benefits. Irisin derives from FNDC5 cleavage induced by PGC-1α and is expressed in muscle and hippocampal brain regions. It is recognized as a mediator between muscle and adipose tissue and a potential carrier of physical activity’s neuroprotective effects. Preclinical studies highlight its role in neuroplasticity and in modulating neuronal proliferation and differentiation. This study aims to assess whether serum irisin levels may predict six-month cognitive function in individuals with osteopenia, osteoporosis, or osteosarcopenia.

Design: This prospective observational study enrolled participants ≥50 years presenting with musculoskeletal fragility, defined as osteopenia, osteoporosis, or osteosarcopenia. At baseline, patients underwent measurement of serum irisin levels and assessment of total energy expenditure expressed in metabolic equivalents, quantified using the Actigraph GT3X+ accelerometer. In addition, comorbidities were recorded using the CIRS. Cognitive performance was evaluated after six months using the MoCA, and participants were classified into two categories: cognitively normal and cognitively impaired. Logistic regression analysis was performed to determine the predictive value of baseline irisin levels on cognitive status at follow-up, adjusting for potential confounders.

Results: Seventy-two patients were included (mean age 63.5 ± 7.4; BMI 25.4 ± 4.2). Higher baseline irisin was significantly associated with a lower likelihood of cognitive impairment at 6-month follow-up, regardless of comorbidities and physical activity ( p = 0.045). Each unit increase in irisin corresponded to a 3.2% lower likelihood of impairment (p = 0.034). These findings suggest a potential protective role of irisin on cognitive trajectories in people with musculoskeletal fragility.

Conclusion: In a population with musculoskeletal frailty, baseline irisin levels predicted cognitive status at 6 months, regardless of clinical factors and lifestyle supporting the potential of irisin as a biomarker of resilience to cognitive decline.