Mark A Espeland1, Owen Carmichael2, Sevil Yasar3, Christina Hugenschmidt4, William Hazzard4, Kathleen M Hayden5, Stephen R Rapp6, Rebecca Neiberg7, Karen C Johnson8, Siobhan Hoscheidt4, Michelle M Mielke9. 1. Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA. Electronic address: mespelan@wakehealth.edu. 2. Pennington Biomedical Research Center, Baton Rouge, LA, USA. 3. Departrment of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA. 4. Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA. 5. Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA. 6. Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA; Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA. 7. Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA. 8. Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA. 9. Departments of Epidemiology and Neurology, Mayo Clinic, Rochester, MN, USA.
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.
RCT Entities:
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.
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