Abstract
| Original language | English |
|---|---|
| Pages (from-to) | 3365-3378 |
| Number of pages | 14 |
| Journal | Alzheimer's & Dementia |
| Volume | 19 |
| Issue number | 8 |
| Early online date | 1 Feb 2023 |
| DOIs | |
| Publication status | Published - Aug 2023 |
Keywords
- ALZHEIMER-DISEASE INCIDENCE
- APOLIPOPROTEIN-E GENOTYPE
- GENDER
- INCIDENCE RATES
- MIDDLE-INCOME COUNTRIES
- POPULATION
- PREVENTION
- TIME
- VASCULAR DEMENTIA
- WOMEN
- data harmonization
- dementia
- diversity
- risk factor
- sex difference
Access to Document
- 10.1002/alz.12962Licence: CC BY
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In: Alzheimer's & Dementia, Vol. 19, No. 8, 08.2023, p. 3365-3378.
Research output: Contribution to journal › Article › Academic › peer-review
TY - JOUR
T1 - Sex differences in dementia risk and risk factors: Individual-participant data analysis using 21 cohorts across six continents from the COSMIC consortium
AU - Gong, J.
AU - Harris, K.
AU - Lipnicki, D.M.
AU - Castro-Costa, E.
AU - Lima-Costa, M.F.
AU - Diniz, B.S.
AU - Xiao, S.F.
AU - Lipton, R.B.
AU - Katz, M.J.
AU - Wang, C.L.
AU - Preux, P.M.
AU - Guerchet, M.
AU - Gbessemehlan, A.
AU - Ritchie, K.
AU - Ancelin, M.L.
AU - Skoog, I.
AU - Najar, J.
AU - Sterner, T.R.
AU - Scarmeas, N.
AU - Yannakoulia, M.
AU - Kosmidis, M.H.
AU - Guaita, A.
AU - Rolandi, E.
AU - Davin, A.
AU - Gureje, O.
AU - Trompet, S.
AU - Gussekloo, J.
AU - Riedel-Heller, S.
AU - Pabst, A.
AU - Rohr, S.
AU - Shahar, S.
AU - Singh, D.K.A.
AU - Rivan, N.F.M.
AU - van Boxtel, M.
AU - Kohler, S.
AU - Ganguli, M.
AU - Chang, C.C.
AU - Jacobsen, E.
AU - Haan, M.
AU - Ding, D.
AU - Zhao, Q.H.
AU - Xiao, Z.X.
AU - Narazaki, K.
AU - Chen, T.
AU - Chen, S.M.
AU - Ng, T.P.
AU - Gwee, X.
AU - Numbers, K.
AU - Mather, K.A.
AU - Scazufca, M.
AU - Cohort Studies of Memory in an International Consortium (COSMIC)
N1 - Funding Information: The COSMIC Research Scientific Committee and additional principal investigators are listed at https://cheba.unsw.edu.au/consortia/cosmic/scientific‐committee . H70‐study thanks the participants of the H70‐study and the members of study groups for their corporation in data collection and management. MYHAT authors thank all study personnel and participants. S.G.S. thanks Dr. Shuzo Kumagai, Dr. Yu Nofuji, Dr. Takanori Honda, and the other contributors to the study. J.G. is supported by the Scientia PhD scholarship from the University of New South Wales, Sydney, Australia ( https://www.scientia.unsw.edu.au/ ). S.A.E.P. is supported by a UK Medical Research Council Skills Development Fellowship (grant number: MR/P014550/1) ( https://mrc.ukri.org/ ). M.W. is supported by an Australian National Health and Medical Research Council Investigator Grant (grant numbers APP1174120 and APP1149987) ( https://www.nhmrc.gov.au/ ). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Funding for COSMIC comes from the National Institute on Aging of the National Institutes of Health (award number: RF1AG057531). EPIDEMCA was supported by a grant from the French National Research Agency (ANR‐09‐MNPS‐009‐01), the AXA Research Fund (2012 – Project – Public Health Institute [Inserm] – PREUX Pierre‐Marie), and the Limoges University Hospital through its APREL scheme. The Hellenic Longitudinal Investigation of Aging and Diet study (HELIAD) was supported by Grant IIRG‐09‐133,014 from the Alzheimer's Association; Grant 18910276/8/9/2011 from the European Social Fund; and Grant ΔΥ2β/οικ0.51657/14.4.2009 from the Ministry of Health and Social Solidarity (Greece). MAAS was funded in part by a grant from the Dutch Ministries of Education and Health and Welfare via the Steering Committee for Gerontological Research. SGS was supported by JSPS KAKENHI Grant Numbers JP17K09146 and JP20H04030. Towards Useful Aging (TUA) cohort was supported by the Long‐term Research Grant Scheme (LGRS) provided by the Ministry of Higher Education, Malaysia (LRGS/1/2019/UM‐UKM/1/4, LRGS/BU/2012/UKM‐UKM/K/01). ZARADEMP was supported by grants from the Fondo de Investigación Sanitaria, Instituto de Salud Carlos III, Spanish Ministry of Economy and Competitiveness, Madrid, Spain (grants 94/1562, 97/1321E, 98/0103, 01/0255, 03/0815, 06/0617, G03/128, 12/02254, 16/00896, 19/01874), and the Fondo Europeo de Desarrollo Regional (FEDER) of the European Union and Gobierno de Aragón, (grant B15_17R). Group #19. M.L., R.L., and C.W. funding from NIH/NIA AG03949. The MYHAT study is funded by research grant #R37AG023651 from the National Institute on Aging, National Institutes of Health, US Department of Health and Human Services. The H70‐study was financed by grants from the Swedish state under the agreement between the Swedish government and the county councils, the ALF‐agreement (ALF965812, ALF 716681), the Swedish Research Council (11267, 2005‐8460, 2007‐7462, 2012‐5041, 2015‐02830, 2019‐01096), the Swedish Research Council RAM (2013‐8717), the Swedish Research Council (NEAR 2017‐00639), the Swedish Research Council for Health, Working Life and Wellfare (2012‐1138, 2013‐1202, 2018‐00471, AGECAP 2013‐2300, no 2013‐2496), Hjärnfonden/Swedish Brain Foundation (FO2014‐0207, FO2016‐0214, FO2018‐0214, FO2019‐0163, FO2020‐0235), Alzheimerfonden (AF‐554461, AF‐647651, AF‐743701, AF‐844671, AF‐930868, AF940139, AF‐968441), and the Alzheimer's Association Zenith Award (ZEN‐01‐3151). Publisher Copyright: © 2023 The Authors. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.
PY - 2023/8
Y1 - 2023/8
N2 - IntroductionSex differences in dementia risk, and risk factor (RF) associations with dementia, remain uncertain across diverse ethno-regional groups. MethodsA total of 29,850 participants (58% women) from 21 cohorts across six continents were included in an individual participant data meta-analysis. Sex-specific hazard ratios (HRs), and women-to-men ratio of hazard ratios (RHRs) for associations between RFs and all-cause dementia were derived from mixed-effect Cox models. ResultsIncident dementia occurred in 2089 (66% women) participants over 4.6 years (median). Women had higher dementia risk (HR, 1.12 [1.02, 1.23]) than men, particularly in low- and lower-middle-income economies. Associations between longer education and former alcohol use with dementia risk (RHR, 1.01 [1.00, 1.03] per year, and 0.55 [0.38, 0.79], respectively) were stronger for men than women; otherwise, there were no discernible sex differences in other RFs. DiscussionDementia risk was higher in women than men, with possible variations by country-level income settings, but most RFs appear to work similarly in women and men.
AB - IntroductionSex differences in dementia risk, and risk factor (RF) associations with dementia, remain uncertain across diverse ethno-regional groups. MethodsA total of 29,850 participants (58% women) from 21 cohorts across six continents were included in an individual participant data meta-analysis. Sex-specific hazard ratios (HRs), and women-to-men ratio of hazard ratios (RHRs) for associations between RFs and all-cause dementia were derived from mixed-effect Cox models. ResultsIncident dementia occurred in 2089 (66% women) participants over 4.6 years (median). Women had higher dementia risk (HR, 1.12 [1.02, 1.23]) than men, particularly in low- and lower-middle-income economies. Associations between longer education and former alcohol use with dementia risk (RHR, 1.01 [1.00, 1.03] per year, and 0.55 [0.38, 0.79], respectively) were stronger for men than women; otherwise, there were no discernible sex differences in other RFs. DiscussionDementia risk was higher in women than men, with possible variations by country-level income settings, but most RFs appear to work similarly in women and men.
KW - ALZHEIMER-DISEASE INCIDENCE
KW - APOLIPOPROTEIN-E GENOTYPE
KW - GENDER
KW - INCIDENCE RATES
KW - MIDDLE-INCOME COUNTRIES
KW - POPULATION
KW - PREVENTION
KW - TIME
KW - VASCULAR DEMENTIA
KW - WOMEN
KW - data harmonization
KW - dementia
KW - diversity
KW - risk factor
KW - sex difference
U2 - 10.1002/alz.12962
DO - 10.1002/alz.12962
M3 - Article
C2 - 36790027
SN - 1552-5260
VL - 19
SP - 3365
EP - 3378
JO - Alzheimer's & Dementia
JF - Alzheimer's & Dementia
IS - 8
ER -