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Alzheimers Dement. 2015 Mar;11(3):310-320. doi: 10.1016/j.jalz.2013.10.005. Epub 2014 Jan 10.

Gender and incidence of dementia in the Framingham Heart Study from mid-adult life.

Author information

1
Inserm U897 & CIC-EC7; Univ Bordeaux Segalen, Isped (Bordeaux School of Public Health); CHU de Bordeaux.
2
Department of Neurology, Boston University School of Medicine, Boston, MA.
3
Department of Biostatistics, Boston University School of Public Health, Boston, MA.
#
Contributed equally

Abstract

BACKGROUND:

Gender-specific risks for dementia and Alzheimer's disease (AD) starting in midlife remain largely unknown.

METHODS:

Prospectively ascertained dementia/AD and cause-specific mortality in Framingham Heart Study (FHS) participants was used to generate 10- to 50-year risk estimates of dementia/AD on the basis of the Kaplan-Meier method (cumulative incidence) or accounting for competing risk of death (lifetime risk [LTR]).

RESULTS:

Overall, 777 cases of incident dementia (601 AD) occurred in 7901 participants (4333 women) over 136,266 person-years. Whereas cumulative incidences were similar in women and men, LTRs were higher in women older than 85 years of age. LTR of dementia/AD at age 45 was 1 in 5 in women and 1 in 10 in men. Cardiovascular mortality was higher in men with rate ratios decreasing from approximately 6 at 45 to 54 years of age to less than 2 after age 65.

CONCLUSION:

Selective survival of men with a healthier cardiovascular risk profile and hence lower propensity to dementia might partly explain the higher LTR of dementia/AD in women.

KEYWORDS:

Alzheimer's disease; Cardiovascular risk profile; Cohort/population-based cohort; Gender; Incidence of dementia; Mortality; Prevention; Selective survival

PMID:
24418058
PMCID:
PMC4092061
DOI:
10.1016/j.jalz.2013.10.005
[Indexed for MEDLINE]
Free PMC Article

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