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

Author:

Gong Jessica12,Harris Katie1,Lipnicki Darren M.3,Castro‐Costa Erico4,Lima‐Costa Maria Fernanda4,Diniz Breno S.5,Xiao Shifu6,Lipton Richard B.7,Katz Mindy J.7,Wang Cuiling8,Preux Pierre‐Marie9,Guerchet Maëlenn9,Gbessemehlan Antoine9,Ritchie Karen10,Ancelin Marie‐Laure10,Skoog Ingmar11,Najar Jenna11,Sterner Therese Rydberg11,Scarmeas Nikolaos1213,Yannakoulia Mary14,Kosmidis Mary H.15,Guaita Antonio16,Rolandi Elena1617,Davin Annalisa16,Gureje Oye18,Trompet Stella19,Gussekloo Jacobijn1920,Riedel‐Heller Steffi21,Pabst Alexander21,Röhr Susanne21,Shahar Suzana22,Singh Devinder Kaur Ajit22,Rivan Nurul Fatin Malek22,Boxtel Martin van23,Köhler Sebastian23,Ganguli Mary24,Chang Chung‐Chou24,Jacobsen Erin24,Haan Mary25,Ding Ding26,Zhao Qianhua26,Xiao Zhenxu26,Narazaki Kenji27,Chen Tao28,Chen Sanmei29,Ng Tze Pin30,Gwee Xinyi30,Numbers Katya3,Mather Karen A.3,Scazufca Marcia31,Lobo Antonio323334,De‐la‐Cámara Concepción3234,Lobo Elena333435,Sachdev Perminder S.3,Brodaty Henry3,Hackett Maree L.136,Peters Sanne A. E.1237,Woodward Mark12,

Affiliation:

1. The George Institute for Global Health University of New South Wales Sydney Australia

2. The George Institute for Global Health Imperial College London London UK

3. Centre for Healthy Brain Ageing (CHeBA) Discipline of Psychiatry and Mental Health Faculty of Medicine and Health UNSW Sydney Sydney Australia

4. Center for Studies in Public Health and Aging Rene Rachou Institute Oswaldo Cruz Foundation Belo Horizonte Brazil

5. UConn Center on Aging Department of Psychiatry School of Medicine University of Connecticut Health Center Farmington Connecticut USA

6. Department of Geriatric Psychiatry Shanghai Mental Health Centre Shanghai Jiaotong University School of Medicine Shanghai China

7. Department of Neurology Albert Einstein College of Medicine Bronx New York USA

8. Department of Epidemiology and Community Heath Albert Einstein College of Medicine Bronx New York USA

9. Inserm U1094, IRD U270, Univ. Limoges CHU Limoges, EpiMaCT ‐ Epidemiology of chronic diseases in tropical zone Institute of Epidemiology and Tropical Neurology OmegaHealth Limoges France

10. INM Institute for Neurosciences of Montpellier Univ Montpellier INSERM Montpellier France

11. Department of Psychiatry and Neurochemistry Center for Ageing and Health (Age Cap) University of Gothenburg Gothenburg Sweden

12. 1st Department of Neurology Aiginition Hospital National and Kapodistrian University of Athens Medical School Athens Greece

13. Department of Neurology Columbia University New York New York USA

14. Department of Nutrition and Dietetics Harokopio University Athens Greece

15. Lab of Cognitive Neuroscience School of Psychology Aristotle University of Thessaloniki Thessaloniki Greece

16. Golgi Cenci Foundation Abbiategrasso Italy

17. Department of Brain and Behavioral Sciences University of Pavia Pavia Italy

18. WHO Collaborating Centre for Research and Training in Mental Health Neurosciences and Substance Abuse Department of Psychiatry University of Ibadan Ibadan Nigeria

19. Section of Gerontology and Geriatrics Department of Internal Medicine Leiden University Medical Center Leiden the Netherlands

20. Department of Public Health and Primary Care Leiden the Netherlands

21. Institute of Social Medicine Occupational Health and Public Health (ISAP) University of Leipzig Leipzig Germany

22. Centre for Healthy Ageing and Wellness Universiti Kebangsaan Malaysia Kuala Lumpur Malaysia

23. Alzheimer Centrum Limburg School for Mental Health and Neuroscience Maastricht University Maastricht the Netherlands

24. Department of Medicine University of Pittsburgh Pittsburgh Pennsylvania USA

25. Department of Epidemiology and Biostatistics School of Medicine University of California, San Francisco San Francisco California USA

26. Institute of Neurology National Center for Neurological Disorders National Clinical Research Center for Aging and Medicine Huashan Hospital Fudan University Shanghai China

27. Center for Liberal Arts Fukuoka Institute of Technology Fukuoka Japan

28. Sports and Health Research Center Department of Physical Education Tongji University Shanghai China

29. Global Health Nursing Department of Health Sciences Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan

30. Gerontology Research Programme Department of Psychological Medicine Yong Loo Lin School of Medicine National University of Singapore Queenstown Singapore

31. Instituto de Psiquiátria e LIM‐23 Hospital da Clínicas Faculdade de Medicina Universidade de São Paulo São Paulo Brazil

32. Department of Medicine and Psychiatry  Universidad de Zaragoza Zaragoza Spain

33. Instituto de Investigación Sanitaria Aragón (IIS Aragón) Zaragoza Spain

34. n°33 CIBERSAM Madrid Spain

35. Department of Public Health  Universidad de Zaragoza Zaragoza Spain

36. Faculty of Health and Wellbeing University of Central Lancashire Lancashire UK

37. Julius Center for Health Sciences and Primary Care University Medical Center Utrecht Utrecht University Utrecht the Netherlands

Abstract

AbstractIntroductionSex 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.

Funder

Agence Nationale de la Recherche

Alzheimer's Association

European Social Fund

Ministry of Higher Education

National Institute on Aging

Vetenskapsrådet

Alzheimerfonden

Publisher

Wiley

Subject

Psychiatry and Mental health,Cellular and Molecular Neuroscience,Geriatrics and Gerontology,Neurology (clinical),Developmental Neuroscience,Health Policy,Epidemiology

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