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P1‐625: PREVALENCE AND INCIDENCE OF MILD COGNITIVE IMPAIRMENT AND DEMENTIA IN FRAIL ELDERS IN LATIN AMERICA, CHINA AND INDIA: A 10/66 POPULATION–BASED SURVEY
Author(s) -
Llibre Rodriguez Juan J.,
Prince Martin J.,
Llibre Guerra Jorge J.,
Prina Matthew,
Acosta Daysi,
Guerra Mariella,
Jimenez-Velazquez Ivonne Z.,
Salas Aquiles,
Sosa-Ortiz Ana Luisa
Publication year - 2018
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2018.06.638
Subject(s) - dementia , medicine , gerontology , incidence (geometry) , population , cohort study , demography , environmental health , disease , physics , pathology , sociology , optics
Background:Both type 2 diabetes (T2D) and obesity in mid-life are associated with increased risk for cognitive decline as individuals age. However, it is unknown whether this results in a different prevalence of cognitive impairment for women and men. It is important to understand the nature of any differences because this may provide clues for the prevention of cognitive decline and dementia. Methods:The Action for Health in Diabetes study was a randomized controlled clinical trial of a ten-year intensive lifestyle intervention targeting weight loss compared with a control group in overweight and obese adults with T2D. At enrollment, when clinical, behavioral, and demographic risk factors for cognitive decline were assessed, participants were aged 45-76 years. Cases of cognitive impairment (mild cognitive impairment or dementia) were adjudicated following this intervention, an average [range] of 11.4 [9.5,13.5] years after enrollment. We examined whether the prevalence of cognitive impairment at this time varied by sex and, if so, whether differences were attributable to risk factor profiles or responses to the intervention and whether these varied across risk factor subgroups. Results:Cognitive assessments were conducted for 3,802 individuals (61% women). The prevalence of cognitive impairment was 8.3% in women and 14.8% in men (adjusted odds ratio 0.55, 95% confidence interval [0.43,0.71], p<0.001). The odds ratio for women compared with men was fairly constant across the age range of the cohort (p1⁄40.669). Risk factor profiles varied between women and men, but did not account for the difference in prevalence. The sex-related difference in prevalence was limited to individuals without APOE-ε4 alleles (p1⁄40.034) and could not be accounted for by differing responses to the lifestyle intervention – markers related to weight control (e.g. changes in weight and physical activity) and diabetes control (e.g. HbA1c or medication use) that were altered by the intervention – or differential follow-up. Conclusions: Among overweight and obese older adults with T2D whowere enrolled in a clinical trial of a behavioral intervention, women had a lower prevalence of cognitive impairment than men, which was not explained by traditional risk factors.