Sex-related differences in cognition and its correlation with lipid parameters and sex steroids among community-dwelling older persons in Nigeria

Abstract

Abstract Introduction: Studies on sex-related differences in cognition and its correlation with serum lipids and sex steroids in older persons in sub-Saharan Africa (SSA) are few and inconsistent. Our objectives were to assess: (i) sex-related differences in cognition and (ii) the correlation of cognition with lipid parameters, age, years of formal education, and sex steroids in community-dwelling older persons in Kano state, Nigeria. Materials and Methods: About 143 eligible participants were randomly selected. We used the Montreal Cognitive Assessment-Basic (MoCA-B), verbal fluency test, 10-Item Word List Learning Test (10-IWLLT), delayed word list recall, and Stick Design Test (SDT) to assess cognitive function. Serum lipids were determined using chemical colorimetry, whereas sex steroids were determined using competitive enzyme-linked immunosorbent assay kits. Results: The results revealed that the participants had a mean age of 66 years. The mean MoCA-B score was 18.84 (males = 20.26, females = 17.73, P = 0.001). Males had better scores in orientation (P = 0.001), abstraction (P = 0.009), naming (P = 0.001), verbal fluency (P = 0.013), delayed word list recall score (P = 0.001), visuo-construction (P = 0.015), and visuo-perception (P = 0.003). Among whole participants, there was a positive correlation between total cholesterol and MoCA-B (r = 0.236, P = 0.005) and between low-density lipoprotein-cholesterol and MoCA-B (r = 0.207, P = 0.013). Serum testosterone had positive correlation with MoCA-B score (r = 0.212, P = 0.001) but negative correlation with delayed word list recall (r = −0.218, P = 0.009), and SDT (r = −0.181, P = 0.031); dihydrotestosterone had positive correlation with MoCA-B score (r = 0.210, P = 0.012) but negative correlation with delayed word list recall (r = −0.243, P = 0.003) and SDT (r = −0.183, P = 0.028). Estradiol had a negative correlation with the 10-IWLLT (r = −0.169, P = 0.044). Conclusion: This study concludes that males had better cognition than females. Higher levels of serum lipids and sex steroids are related to better cognition in community-dwelling older persons in Nigeria.