Sex-related Differences in the Prevalence of Cognitive Impairment Among Overweight and Obese Adults with Type 2 Diabetes

Overview

Journal Alzheimers Dement

Specialties Neurology
Psychiatry

Date 2018 Sep 12

PMID 30201101

Citations 18

Authors

Mark A Espeland

Owen Carmichael

Sevil Yasar

Christina Hugenschmidt

William Hazzard

Kathleen M Hayden

Stephen R Rapp

Rebecca Neiberg

Karen C Johnson

Siobhan Hoscheidt

Michelle M Mielke

Affiliations

Soon will be listed here.

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.

Citing Articles

Body roundness index and cognitive function in older adults: a nationwide perspective.

Zhang F, Ning Z, Wang C Front Aging Neurosci. 2024; 16:1466464.

PMID: 39634656 PMC: 11616450. DOI: 10.3389/fnagi.2024.1466464.

Predictors of Cognitive Impairment among Filipino Patients with Type 2 Diabetes Mellitus in a Tertiary Government Hospital.

Carandang R, Ong M, Malenab R Acta Med Philipp. 2024; 58(14):6-12.

PMID: 39238555 PMC: 11372423. DOI: 10.47895/amp.vi0.7648.

Dysglycemia, gender, and cognitive performance in older persons living with mild cognitive impairment: findings from a cross-sectional, population-based study.

Boccardi V, Travaglini E, Sciacca E, Mancinetti F, Murasecco I, Guazzarini A Aging Clin Exp Res. 2024; 36(1):145.

PMID: 39012506 PMC: 11252216. DOI: 10.1007/s40520-024-02806-7.

Diabetes mellitus and risk of incident dementia in APOE ɛ4 carriers: an updated meta-analysis.

Rashtchian A, Etemadi M, Asadi E, Binaei S, Abbasi M, Bayani M BMC Neurosci. 2024; 25(1):28.

PMID: 38918708 PMC: 11201872. DOI: 10.1186/s12868-024-00878-9.

Prediction Model for Cognitive Impairment among Disabled Older Adults: A Development and Validation Study.

Cui X, Zheng X, Lu Y Healthcare (Basel). 2024; 12(10).

PMID: 38786438 PMC: 11121056. DOI: 10.3390/healthcare12101028.

References

Ryan D, Espeland M, Foster G, Haffner S, Hubbard V, Johnson K . Look AHEAD (Action for Health in Diabetes): design and methods for a clinical trial of weight loss for the prevention of cardiovascular disease in type 2 diabetes. Control Clin Trials. 2003; 24(5):610-28. DOI: 10.1016/s0197-2456(03)00064-3. View

Pfeffer R, Kurosaki T, Harrah Jr C, Chance J, Filos S . Measurement of functional activities in older adults in the community. J Gerontol. 1982; 37(3):323-9. DOI: 10.1093/geronj/37.3.323. View

Henderson V, St John J, Hodis H, McCleary C, Stanczyk F, Shoupe D . Cognitive effects of estradiol after menopause: A randomized trial of the timing hypothesis. Neurology. 2016; 87(7):699-708. PMC: 4999165. DOI: 10.1212/WNL.0000000000002980. View

Espeland M, Luchsinger J, Baker L, Neiberg R, Kahn S, Arnold S . Effect of a long-term intensive lifestyle intervention on prevalence of cognitive impairment. Neurology. 2017; 88(21):2026-2035. PMC: 5440245. DOI: 10.1212/WNL.0000000000003955. View

Asih P, Tegg M, Sohrabi H, Carruthers M, Gandy S, Saad F . Multiple Mechanisms Linking Type 2 Diabetes and Alzheimer's Disease: Testosterone as a Modifier. J Alzheimers Dis. 2017; 59(2):445-466. PMC: 6462402. DOI: 10.3233/JAD-161259. View

Miller V, Garovic V, Kantarci K, Barnes J, Jayachandran M, Mielke M . Sex-specific risk of cardiovascular disease and cognitive decline: pregnancy and menopause. Biol Sex Differ. 2013; 4(1):6. PMC: 3623746. DOI: 10.1186/2042-6410-4-6. View

Weuve J, Tchetgen Tchetgen E, Glymour M, Beck T, Aggarwal N, Wilson R . Accounting for bias due to selective attrition: the example of smoking and cognitive decline. Epidemiology. 2011; 23(1):119-28. PMC: 3237815. DOI: 10.1097/EDE.0b013e318230e861. View

Liedtke S, Schmidt M, Vrieling A, Lukanova A, Becker S, Kaaks R . Postmenopausal sex hormones in relation to body fat distribution. Obesity (Silver Spring). 2012; 20(5):1088-95. DOI: 10.1038/oby.2011.383. View

Zhao L, Mao Z, Woody S, Brinton R . Sex differences in metabolic aging of the brain: insights into female susceptibility to Alzheimer's disease. Neurobiol Aging. 2016; 42:69-79. PMC: 5644989. DOI: 10.1016/j.neurobiolaging.2016.02.011. View

10.

Wing R, Bolin P, Brancati F, Bray G, Clark J, Coday M . Cardiovascular effects of intensive lifestyle intervention in type 2 diabetes. N Engl J Med. 2013; 369(2):145-54. PMC: 3791615. DOI: 10.1056/NEJMoa1212914. View

11.

West N, Haan M . Body adiposity in late life and risk of dementia or cognitive impairment in a longitudinal community-based study. J Gerontol A Biol Sci Med Sci. 2009; 64(1):103-9. PMC: 2691186. DOI: 10.1093/gerona/gln006. View

12.

Chatterjee S, Peters S, Woodward M, Mejia Arango S, Batty G, Beckett N . Type 2 Diabetes as a Risk Factor for Dementia in Women Compared With Men: A Pooled Analysis of 2.3 Million People Comprising More Than 100,000 Cases of Dementia. Diabetes Care. 2015; 39(2):300-7. PMC: 4722942. DOI: 10.2337/dc15-1588. View

13.

Espeland M, Rapp S, Shumaker S, Brunner R, Manson J, Sherwin B . Conjugated equine estrogens and global cognitive function in postmenopausal women: Women's Health Initiative Memory Study. JAMA. 2004; 291(24):2959-68. DOI: 10.1001/jama.291.24.2959. View

14.

Tiehuis A, van der Graaf Y, Mali W, Vincken K, Muller M, Geerlings M . Metabolic syndrome, prediabetes, and brain abnormalities on mri in patients with manifest arterial disease: the SMART-MR study. Diabetes Care. 2014; 37(9):2515-21. DOI: 10.2337/dc14-0154. View

15.

Kim Y, Kim N, Jung M, Kim H . Sex differences in metabolic risk indicator of dementia in an elderly urban Korean population: A community-based cross-sectional study. Geriatr Gerontol Int. 2017; 17(11):2136-2142. DOI: 10.1111/ggi.13049. View

16.

Espeland M, Brinton R, Manson J, Yaffe K, Hugenschmidt C, Vaughan L . Postmenopausal hormone therapy, type 2 diabetes mellitus, and brain volumes. Neurology. 2015; 85(13):1131-8. PMC: 4603880. DOI: 10.1212/WNL.0000000000001816. View

17.

Elias M, Elias P, Sullivan L, Wolf P, DAgostino R . Obesity, diabetes and cognitive deficit: The Framingham Heart Study. Neurobiol Aging. 2005; 26 Suppl 1:11-6. DOI: 10.1016/j.neurobiolaging.2005.08.019. View

18.

Wadden T, West D, Delahanty L, Jakicic J, Rejeski J, Williamson D . The Look AHEAD study: a description of the lifestyle intervention and the evidence supporting it. Obesity (Silver Spring). 2006; 14(5):737-52. PMC: 2613279. DOI: 10.1038/oby.2006.84. View

19.

Espeland M, Shumaker S, Leng I, Manson J, Brown C, LeBlanc E . Long-term effects on cognitive function of postmenopausal hormone therapy prescribed to women aged 50 to 55 years. JAMA Intern Med. 2013; 173(15):1429-36. PMC: 3844547. DOI: 10.1001/jamainternmed.2013.7727. View

20.

Wang K, Woung L, Tsai M, Liu C, Su Y, Li C . Risk of Alzheimer's disease in relation to diabetes: a population-based cohort study. Neuroepidemiology. 2012; 38(4):237-44. DOI: 10.1159/000337428. View