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- Title
Sex differences in the association between cardiovascular diseases and dementia subtypes: a prospective analysis of 464,616 UK Biobank participants.
- Authors
Dong, Caiyun; Zhou, Chunmiao; Fu, Chunying; Hao, Wenting; Ozaki, Akihiko; Shrestha, Nipun; Virani, Salim S.; Mishra, Shiva Raj; Zhu, Dongshan
- Abstract
Background: Whether the association of cardiovascular diseases (CVDs) with dementia differs by sex remains unclear, and the role of socioeconomic, lifestyle, genetic, and medical factors in their association is unknown. Methods: We used data from the UK Biobank, a population-based cohort study of 502,649 individuals. We used Cox proportional hazards models to estimate sex-specific hazard ratios (HRs) and 95% confidence intervals (CI), and women-to-men ratio of HRs (RHR) for the association between CVD (coronary heart diseases (CHD), stroke, and heart failure) and incident dementia (all-cause dementia, Alzheimer's Disease (AD), and vascular dementia (VD)). The moderator roles of socioeconomic (education, income), lifestyle (smoking, BMI, leisure activities, and physical activity), genetic factors (APOE allele status), and medical history were also analyzed. Results: Compared to people who did not experience a CVD event, the HRs (95%CI) between CVD and all-cause dementia were higher in women compared to men, with an RHR (Female/Male) of 1.20 (1.13, 1.28). Specifically, the HRs for AD were higher in women with CHD and heart failure compared to men, with an RHR (95%CI) of 1.63 (1.39, 1.91) and 1.32 (1.07, 1.62) respectively. The HRs for VD were higher in men with heart failure than women, with RHR (95%CI) of 0.73 (0.57, 0.93). An interaction effect was observed between socioeconomic, lifestyle, genetic factors, and medical history in the sex-specific association between CVD and dementia. Conclusion: Women with CVD were 1.5 times more likely to experience AD than men, while had 15% lower risk of having VD than men. Highlights: Whether the incidence and timing of dementia is affected by an interaction of sex with cardiovascular diseases (CVD) events is unclear. We evaluated the sex-specific difference in dementia risk associated with CVDs, including its unique interaction with social, behavioral, genetic, and medical factors. Women with coronary heart disease and heart failure were 1.6 and 1.3 times more likely to develop Alzheimer's disease than men with the same condition. Men with heart failure had 1.4 times higher risk of having vascular dementia than women. Socioeconomic, lifestyle, genetic, and medical factors moderated the sex-specific association between CVD and dementia.
- Subjects
UNITED Kingdom; PROPORTIONAL hazards models; CARDIOVASCULAR diseases; SEX factors in disease; HEART diseases in women; VASCULAR dementia; DEMENTIA; CARDIOVASCULAR fitness
- Publication
Biology of Sex Differences, 2022, Vol 13, Issue 1, p1
- ISSN
2042-6410
- Publication type
Article
- DOI
10.1186/s13293-022-00431-5