Volume 11, Issue 3 p. 310-320
Featured Article

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

Geneviève Chêne

Corresponding Author

Geneviève Chêne

Inserm U897 and CIC-EC7, University of Bordeaux Segalen, Isped (Bordeaux School of Public Health), CHU de Bordeaux, Bordeaux, France

Corresponding author. Tel.: +33 (0)557 57 12 57; Fax: +33 (0)557 57 11 72.

E-mail address: [email protected]

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Alexa Beiser

Alexa Beiser

Department of Neurology, Boston University School of Medicine, Boston, MA, USA

Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA

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Rhoda Au

Rhoda Au

Department of Neurology, Boston University School of Medicine, Boston, MA, USA

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Sarah R. Preis

Sarah R. Preis

Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA

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Philip A. Wolf

Philip A. Wolf

Department of Neurology, Boston University School of Medicine, Boston, MA, USA

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Carole Dufouil

Carole Dufouil

Inserm U897 and CIC-EC7, University of Bordeaux Segalen, Isped (Bordeaux School of Public Health), CHU de Bordeaux, Bordeaux, France

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Sudha Seshadri

Sudha Seshadri

Department of Neurology, Boston University School of Medicine, Boston, MA, USA

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First published: 13 January 2014
Citations: 232

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.