The George Institute for Global Health, University of New South Wales, Sydney, Australia.
The George Institute for Global Health, Imperial College London, London, UK.
Alzheimers Dement. 2023 Aug;19(8):3365-3378. doi: 10.1002/alz.12962. Epub 2023 Feb 15.
Sex differences in dementia risk, and risk factor (RF) associations with dementia, remain uncertain across diverse ethno-regional groups.
A total of 29,850 participants (58% women) from 21 cohorts across six continents were included in an individual participant data meta-analysis. Sex-specific hazard ratios (HRs), and women-to-men ratio of hazard ratios (RHRs) for associations between RFs and all-cause dementia were derived from mixed-effect Cox models.
Incident dementia occurred in 2089 (66% women) participants over 4.6 years (median). Women had higher dementia risk (HR, 1.12 [1.02, 1.23]) than men, particularly in low- and lower-middle-income economies. Associations between longer education and former alcohol use with dementia risk (RHR, 1.01 [1.00, 1.03] per year, and 0.55 [0.38, 0.79], respectively) were stronger for men than women; otherwise, there were no discernible sex differences in other RFs.
Dementia risk was higher in women than men, with possible variations by country-level income settings, but most RFs appear to work similarly in women and men.
痴呆风险在不同的种族和地区群体中存在性别差异，风险因素（RF）与痴呆的关联也不确定。
共有来自六大洲 21 个队列的 29850 名参与者（58%为女性）纳入了一项个体参与者数据荟萃分析。采用混合效应 Cox 模型得出 RF 与全因痴呆之间的关联的性别特异性危险比（HR）和女性与男性的危险比（RHR）。
在 4.6 年（中位数）的时间里，2089 名（66%为女性）参与者发生了新发痴呆。女性的痴呆风险（HR，1.12 [1.02，1.23]）高于男性，尤其是在低收入和中下收入经济体中。与较长的教育年限和以前的饮酒与痴呆风险相关（RHR，每年 1.01 [1.00，1.03]和 0.55 [0.38，0.79]）的关联在男性中强于女性；否则，在其他 RF 中没有明显的性别差异。
女性的痴呆风险高于男性，可能因国家收入水平而异，但大多数 RF 在女性和男性中的作用似乎相似。
