Sex differences in dementia risk and risk factors: Individual-participant data analysis using 21 cohorts across six continents from the COSMIC consortium

Publication date

2023-08

Authors

Gong, Jessica
Harris, Katie
Lipnicki, Darren M.
Castro-Costa, Erico
Lima-Costa, Maria Fernanda
Diniz, Breno S.
Xiao, Shifu
Lipton, Richard B.
Katz, Mindy J.
Wang, Cuiling

Editors

Advisors

Supervisors

Document Type

Article

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cc_by

Abstract

Introduction: Sex differences in dementia risk, and risk factor (RF) associations with dementia, remain uncertain across diverse ethno-regional groups. Methods: A 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. Results: Incident 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. Discussion: Dementia 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.

Keywords

data harmonization, dementia, diversity, risk factor, sex difference, Epidemiology, Health Policy, Developmental Neuroscience, Clinical Neurology, Geriatrics and Gerontology, Cellular and Molecular Neuroscience, Psychiatry and Mental health

Citation

Gong, J, Harris, K, Lipnicki, D M, Castro-Costa, E, Lima-Costa, M F, Diniz, B S, Xiao, S, Lipton, R B, Katz, M J, Wang, C, Preux, P M, Guerchet, M, Gbessemehlan, A, Ritchie, K, Ancelin, M L, Skoog, I, Najar, J, Sterner, T R, Scarmeas, N, Yannakoulia, M, Kosmidis, M H, Guaita, A, Rolandi, E, Davin, A, Gureje, O, Trompet, S, Gussekloo, J, Riedel-Heller, S, Pabst, A, Röhr, S, Shahar, S, Singh, D K A, Rivan, N F M, Boxtel, M V, Köhler, S, Ganguli, M, Chang, C C, Jacobsen, E, Haan, M, Ding, D, Zhao, Q, Xiao, Z, Narazaki, K, Chen, T, Chen, S, Ng, T P, Gwee, X, Numbers, K, Mather, K A, Scazufca, M, Lobo, A, De-la-Cámara, C, Lobo, E, Sachdev, P S, Brodaty, H, Hackett, M L, Peters, S A E & Woodward, M 2023, 'Sex differences in dementia risk and risk factors : Individual-participant data analysis using 21 cohorts across six continents from the COSMIC consortium', Alzheimer's and Dementia, vol. 19, no. 8, doi.org/10.1002/alz.12962, pp. 3365-3378. https://doi.org/10.1002/alz.12962