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

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


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: NCT00017953.

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

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, N.I.H., Intramural
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Behavior Therapy
  • Cognitive Dysfunction / epidemiology*
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / complications*
  • Female
  • Humans
  • Life Style
  • Male
  • Middle Aged
  • Obesity / complications*
  • Overweight / complications*
  • Prevalence
  • Sex Characteristics*

Associated data