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Randomized Controlled Trial
. 2018 Sep;14(9):1184-1192.
doi: 10.1016/j.jalz.2018.05.015. Epub 2018 Jul 5.

Sex-related differences in the prevalence of cognitive impairment among overweight and obese adults with type 2 diabetes

Mark A Espeland  1 , Owen Carmichael  2 , Sevil Yasar  3 , Christina Hugenschmidt  4 , William Hazzard  4 , Kathleen M Hayden  5 , Stephen R Rapp  6 , Rebecca Neiberg  7 , Karen C Johnson  8 , Siobhan Hoscheidt  4 , Michelle M Mielke  9 ; Action for Health in Diabetes (Look AHEAD) Research Group
Affiliations
Randomized Controlled Trial

Sex-related differences in the prevalence of cognitive impairment among overweight and obese adults with type 2 diabetes

Mark A Espeland et al. Alzheimers Dement. 2018 Sep.

Abstract

Introduction: Type 2 diabetes mellitus and obesity may increase risks for cognitive decline as individuals age. It is unknown whether this results in different prevalences of cognitive impairment for women and men.

Methods: The Action for Health in Diabetes, a randomized controlled clinical trial of a 10-year intensive lifestyle intervention, adjudicated cases of cross-sectional cognitive impairment (mild cognitive impairment or dementia) 10-13 years after enrollment in 3802 individuals (61% women).

Results: The cross-sectional prevalences of cognitive impairment were 8.3% (women) and 14.8% (men): adjusted odds ratio 0.55, 95% confidence interval [0.43, 0.71], P < .001. Demographic, clinical, and lifestyle risk factors varied between women and men but did not account for this difference, which was limited to individuals without apolipoprotein E (APOE)-ε4 alleles (interaction P = .034).

Conclusions: Among overweight and obese adults with type 2 diabetes mellitus, traditional risk factors did not account for the lower prevalence of cognitive impairment observed in women compared with men.

Trial registration: ClinicalTrials.gov NCT00017953.

Keywords: Cognitive impairment; Obesity; Risk factors; Sex differences; Type 2 diabetes mellitus.

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Conflict of interest statement

Conflicts of interest: The authors have no conflicts to report. ClinicalTrials.gov Identifier: NCT00017953.

Figures

Fig. 1.
Fig. 1.
Prevalence of cognitive impairment (mild cognitive impairment or dementia) by age and sex (interaction P = .669).
Fig. 2.
Fig. 2.
Probability estimates from a multivariable logistic regression model for cognitive impairment (mild cognitive impairment or dementia) that includes age, history of cardiovascular disease, education, and depression symptoms as predictors.
See this image and copyright information in PMC

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