在痴呆风险和风险因素方面的性别差异：来自 COSMIC 联盟的六大洲 21 个队列的个体参与者数据分析。
Sex differences in dementia risk and risk factors: Individual-participant data analysis using 21 cohorts across six continents from the COSMIC consortium.
机构信息
The George Institute for Global Health, University of New South Wales, Sydney, Australia.
The George Institute for Global Health, Imperial College London, London, UK.
出版信息
Alzheimers Dement. 2023 Aug;19(8):3365-3378. doi: 10.1002/alz.12962. Epub 2023 Feb 15.
INTRODUCTION
Sex differences in dementia risk, and risk factor (RF) associations with dementia, remain uncertain across diverse ethno-regional groups.
METHODS
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.
RESULTS
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.
DISCUSSION
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.
简介
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。
方法
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）。
结果
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。
讨论
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。
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