Cortical Complications of Perimenopause and Obstructive Sleep Apnea in Underrepresented Middle-Aged Women with Type 2 Diabetes

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Abstract More than 34 million individuals in the U.S. are living with Type 2 Diabetes (DM). Adult females who belong to underrepresented racial and ethnic groups are most negatively impacted by risks and complications associated with DM, including functional impairment in cognitive and sensorimotor actions. Prior work in understanding the cortical complications in persons with DM (including the development of vascular dementia (VD)) has focused on independent risk factors such as insufficient sleep and inflammation. DM complications have also been linked to obstructive sleep apnea (OSA) and sex-hormone changes during the transition to menopause; however, most studies have included only white non-Hispanic persons. Due to this, we have limited insight into the multifactorial causes of poor cortical health including DM, sex-hormone influences, inflammation, and OSA in the most dramatically impacted population living with DM—underrepresented women. In this project, we seek to fill this critical gap by clarifying how sex-hormones (estrogen and testosterone), inflammation, and OSA contribute together to the pathogenesis of cortical complications in underrepresented women living with DM. This proposed project is a logical extension of our recent work that provides mechanistic insight into the compound contributions of menopause and inflammation to cortical complications and functional impairment in underrepresented women with DM. Findings from this study will advance understanding of poor cortical health as a combined function of sex-hormone changes, inflammation, and OSA in underrepresented middle-aged women with DM. This information pushes forward beyond the knowledge of DM, insufficient sleep, inflammation, and underrepresented minority status as independent risk factors for VD development. This project aligns with NHLBI objectives of prevention of heart, lung, blood, and sleep diseases and priorities in in women’s health, sleep disorders, health disparities, and VD.