Ruitenberg A, Ott A, van Swieten J C, Hofman A, Breteler M M
Department of Epidemiology & Biostatistics, Erasmus Medical Center, Rotterdam, The Netherlands.
Neurobiol Aging. 2001 Jul-Aug;22(4):575-80. doi: 10.1016/s0197-4580(01)00231-7.
Several studies suggested that women are at higher risk of dementia than men. However, that was based on rather limited data. We investigated possible gender differences in the incidence of dementia, Alzheimer's disease and vascular dementia, in the Rotterdam Study, a large population based prospective cohort study in the Netherlands of 7,046 persons aged 55 years and older, free of dementia at baseline. In 40,441 person-years of follow-up (mean 5.7 years) we identified 395 new cases of dementia (overall incidence: 9.8 per 1,000 person-years). Alzheimer's disease was the most frequent subtype of dementia (293 cases; 7.2 per 1,000). Vascular dementia was diagnosed in 57 participants (1.5 per 1,000). Overall, dementia incidence was similar for men and women (rate ratio women versus men: 1.00, 95% CI: 0.80-1.24). However, after 90 years of age dementia incidence declined in men but not in women (rate ratio 2.61, 95% CI: 1.04-6.56), in particular for Alzheimer's disease (rate ratio 5.79, 95% CI: 1.40-23.90). The overall incidence of vascular dementia was lower in women than in men (rate ratio 0.57, 95% CI: 0.34-0.97). This large population-based study suggests no gender differences in the incidence of dementia up to high age. After 90 years of age the incidence of Alzheimer's disease is higher for women than for men. The incidence of vascular dementia is higher for men than for women in all age groups.
多项研究表明，女性患痴呆症的风险高于男性。然而，这是基于相当有限的数据得出的结论。我们在鹿特丹研究中调查了痴呆症、阿尔茨海默病和血管性痴呆发病率可能存在的性别差异。该研究是在荷兰进行的一项大型基于人群的前瞻性队列研究，共有7046名55岁及以上的人参与，这些人在基线时均无痴呆症。在40441人年的随访期（平均5.7年）内，我们共识别出395例新发痴呆症病例（总体发病率：每1000人年9.8例）。阿尔茨海默病是痴呆症最常见的亚型（293例；每1000人年7.2例）。57名参与者被诊断为血管性痴呆（每1000人年1.5例）。总体而言，男性和女性的痴呆症发病率相似（女性与男性的发病率比值：1.00，95%置信区间：0.80 - 1.24）。然而，90岁以后，男性的痴呆症发病率下降，而女性则没有（发病率比值2.61，95%置信区间：1.04 - 6.56），尤其是阿尔茨海默病（发病率比值5.79，95%置信区间：1.40 - 23.90）。女性血管性痴呆的总体发病率低于男性（发病率比值0.57，95%置信区间：0.34 - 0.97）。这项大型基于人群的研究表明，在高龄之前，痴呆症发病率不存在性别差异。90岁以后，女性患阿尔茨海默病的发病率高于男性。在所有年龄组中，男性患血管性痴呆的发病率高于女性。
