Gender Differences in the Relationship between Perceived Discrimination and Dementia among Older Adults with Diabetes in High- and Middle-Income Countries

Introduction and Objective: The purpose of this study was to assess the relationship gender differences between perceived discrimination and dementia among older adults with diabetes in high- and middle-income countries. Methods: Data of 75,188 men and women ≥50 years of age with diabetes from the Health and Retirement International Family of Studies were analyzed (1,780 from the 2019-2021 Brazilian Longitudinal Study of Aging; and 73,408 from the 2017-2019 Longitudinal Aging Study in India. The outcome was self-reported dementia. The independent variable was perceived discrimination assessed as 1) when seeking medical services or 2) received poorer quality medical or hospital treatment compared to others in Brazil; and discrimination based on financial status in India. Covariates were age, marital status, urban/rural residence, wealth (Brazil), and education (India). Unadjusted and adjusted logistic regression models were used to investigate the relationship between dementia and perceived discrimination. Results: The prevalence of dementia in men with diabetes was 5.1% and 0.82% in Brazil and India compared to 5.2% and 0.87% among women in those countries, respectively. In adjusted models, there was no significant relationship among men (OR:1.51; 95%CI:0.18, 12.8) nor women (OR:1.58; 95%CI:0.35,7.10) with diabetes when seeking medical services or for women (OR:1.87; 95%CI:0.54,6.44) in the quality of medical and health services in Brazil. However, among men, the relationship between discrimination and the quality of medical and health services in Brazil was significant (OR:5.82; 95%CI:1.72,19.7). In India, there was a significant relationship between dementia and discrimination based on financial status for men (OR:7.35;95%CI:2.63,20.53) and women (OR:4.01;95%CI:1.47,10.93). Conclusion: There were significant relationships between dementia and quality of medical and health services among men in Brazil and financial status among both men and women in India. Disclosure: J.S. Williams: None. A.Z. Dawson: None. Funding: National Institutes of Health (R01DK135838)