Sex differences in dementia risk and risk factors: Individual-participant data analysis using 21 cohorts across six continents from the COSMIC consortium.
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Date
2023-08-01
Open Access Location
Journal Title
Journal ISSN
Volume Title
Publisher
John Wiley and Sons, Inc.
Rights
(c) 2023 The Author/s
CC BY 4.0
CC BY 4.0
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.
Description
Keywords
data harmonization, dementia, diversity, risk factor, sex difference, Humans, Male, Female, Sex Characteristics, Risk Factors, Alcohol Drinking, Dementia, Sex Factors
Citation
Gong J, Harris K, Lipnicki DM, Castro-Costa E, Lima-Costa MF, Diniz BS, Xiao S, Lipton RB, Katz MJ, Wang C, Preux P-M, Guerchet M, Gbessemehlan A, Ritchie K, Ancelin M-L, Skoog I, Najar J, Sterner TR, Scarmeas N, Yannakoulia M, Kosmidis MH, Guaita A, Rolandi E, Davin A, Gureje O, Trompet S, Gussekloo J, Riedel-Heller S, Pabst A, Röhr S, Shahar S, Singh DKA, Rivan NFM, Boxtel MV, Köhler S, Ganguli M, Chang C-C, Jacobsen E, Haan M, Ding D, Zhao Q, Xiao Z, Narazaki K, Chen T, Chen S, Ng TP, Gwee X, Numbers K, Mather KA, Scazufca M, Lobo A, De-la-Cámara C, Lobo E, Sachdev PS, Brodaty H, Hackett ML, Peters SAE, Woodward M, Cohort Studies of Memory in an International Consortium (COSMIC) . (2023). Sex differences in dementia risk and risk factors: Individual-participant data analysis using 21 cohorts across six continents from the COSMIC consortium.. Alzheimers Dement. 19. 8. (pp. 3365-3378).