Sex-dependent association between selenium status and cognitive performance in older adults

Selenium (Se) is an essential nutrient required for maintaining brain health across lifespan, and adequate nutritional Se status has been positively associated with sustained cognitive performance in older adults. However, critical physiological sex differences in Se metabolism have not been specifically assessed in human studies. Therefore, we aimed to investigate sex differences in the association between Se concentration in whole blood and cognitive performance in US older adults.

This cross-sectional study included 2016 participants (984 male and 1032 female) ≥ 60 years from the 2011 to 2014 National Health and Nutrition Survey (NHANES). All participants were assessed for whole blood Se concentration and completed the following battery of cognitive tests: Consortium to Establish a Registry for Alzheimer's Disease (CERAD) Word Learning Test, Animal Fluency test, and Digit Symbol Substitution Test (DSST).

In this cohort, all participants presented with adequate Se status (mean 196.7 μg/L; 95% CI 193.5, 200.0), and cohort-wide scores were equivalent to a cognitively healthy population. A sex effect on CERAD recall (P = 0.005) and animal fluency (P = 0.018) was observed in models adjusted for age, diabetes, history of cardiovascular disease, physical activity and body mass index. Se concentration was positively associated with CERAD recall (β: 0.015, 95% CI 0.007, 0.022) and animal fluency (β: 0.017, 95% CI 0.003, 0.030) performance in males only, while no associations were observed for females.

This study provides the first evidence for sex differences in the association between Se status and cognitive performance in older adults.