Sex, diabetes status and cognition: findings from the study of longevity in diabetes
Open Access
- 28 January 2021
- journal article
- research article
- Published by BMJ in BMJ Open Diabetes Research & Care
- Vol. 9 (1), e001646
- https://doi.org/10.1136/bmjdrc-2020-001646
Abstract
Introduction Women comprise two-thirds of people with dementia, making female sex a significant dementia risk factor. Both type 1 diabetes (T1D) and type 2 diabetes (T2D) are known dementia risk factors with an increasing global incidence. Understanding whether subtle sex differences persist in cognitive function prior to dementia in the context of diabetes may help elucidate the magnitude of sex effects on dementia risk. Research design and methods We examined cross-sectional data from the Study of Longevity in Diabetes (SOLID), a prospective cohort study of members of Kaiser Permanente Northern California aged 60 years and older with T1D (n=758), T2D (n=232) and without either T1D or T2D (n=247). We used factor analysis to generate summary scores of cognitive domains and used regression analyses to examine the associations between sex and cognition adjusting for sociodemographic and cardiovascular confounders. Results We included 1237 participants (630 women and 607 men) with mean age 68 years. By design, the distribution of men and women in T1D, T2D and no diabetes was similar. Women had better cognitive performance than men in global cognition (β=0.21, 95% CI 0.16 to 0.26), language (β=0.08, 95% CI 0.004 to 0.15), executive function (β=0.13, 95% CI 0.05 to 0.20), episodic verbal memory (β=0.68, 95% CI 0.59 to 0.77) and attention (β=0.20, 95% CI 0.11 to 0.28) but not in episodic visual memory (β=0.006, 95% CI −0.07 to 0.09) adjusting for age and education independent of diabetes status. We did not find an interaction between sex and diabetes status for any of the cognitive outcomes. Conclusions Women in late mid-life have better cognitive performance than men in many cognitive domains independent of the presence of T1D or T2D. Further work is required to understand whether these differences change over time or in older cohorts and to understand their relationship to subsequent dementia.Keywords
Funding Information
- Alzheimer's Association (2019-AARGD-644788)
- National Institute on Aging (AG047500)
This publication has 51 references indexed in Scilit:
- Protective actions of sex steroid hormones in Alzheimer’s diseaseFrontiers in Neuroendocrinology, 2009
- Incidence trends for childhood type 1 diabetes in Europe during 1989–2003 and predicted new cases 2005–20: a multicentre prospective registration studyThe Lancet, 2009
- Reversibility of the effects of acute ovarian hormone suppression on verbal memory and prefrontal function in pre-menopausal womenPsychoneuroendocrinology, 2008
- Aging, gender, and the elderly adult brain: An examination of analytical strategiesNeurobiology of Aging, 2008
- Risk profiles for mild cognitive impairment and progression to dementia are gender specificJournal of Neurology, Neurosurgery & Psychiatry, 2008
- Development and Validation of a Short-Form, Rapid Estimate of Adult Literacy in MedicineMedical Care, 2007
- Sex differences in regional gray matter in healthy individuals aged 44–48 years: A voxel-based morphometric studyNeuroImage, 2007
- Surgical versus natural menopauseMenopause, 2007
- Measures of brain morphology and infarction in the framingham heart study: establishing what is normalNeurobiology of Aging, 2005
- A Voxel-Based Morphometric Study of Ageing in 465 Normal Adult Human BrainsNeuroImage, 2001