Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China.
NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China.
Biol Sex Differ. 2022 May 7;13(1):21. doi: 10.1186/s13293-022-00431-5.
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.
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.
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.
Women with CVD were 1.5 times more likely to experience AD than men, while had 15% lower risk of having VD than men.
心血管疾病（CVDs）与痴呆的相关性是否因性别而异尚不清楚，其相关性的社会经济、生活方式、遗传和医疗因素的作用也不清楚。
我们使用了 UK Biobank 的数据，这是一项针对 502649 名个体的基于人群的队列研究。我们使用 Cox 比例风险模型来估计 CVD（冠心病、中风和心力衰竭）与痴呆（全因痴呆、阿尔茨海默病（AD）和血管性痴呆（VD））发病风险之间的性别特异性危险比（HR）和 95%置信区间（CI），以及女性与男性 HR 比值（RHR）。还分析了社会经济（教育、收入）、生活方式（吸烟、BMI、休闲活动和体力活动）、遗传因素（APOE 等位基因状态）和病史的调节作用。
与未发生 CVD 事件的人相比，女性 CVD 与全因痴呆的 HR（95%CI）高于男性，RHR（女性/男性）为 1.20（1.13，1.28）。具体而言，与男性相比，患有 CHD 和心力衰竭的女性 AD 的 HR 更高，RHR（95%CI）分别为 1.63（1.39，1.91）和 1.32（1.07，1.62）。与女性相比，心力衰竭的男性 VD 的 HR 更高，RHR（95%CI）为 0.73（0.57，0.93）。在 CVD 与痴呆的性别特异性相关性中，观察到社会经济、生活方式、遗传因素和病史之间存在交互作用。
女性 CVD 患者患 AD 的可能性比男性高 1.5 倍，而患 VD 的风险比男性低 15%。
