title: Gender and incidence of dementia in the Framingham Heart Study from mid-adult life.
abstract: BACKGROUND
  Gender-specific risks for dementia and Alzheimer's disease (AD) starting in midlife remain largely unknown.
  
  
  METHODS
  Prospectively ascertained dementia/AD and cause-specific mortality in Framingham Heart Study (FHS) participants was used to generate 10- to 50-year risk estimates of dementia/AD on the basis of the Kaplan-Meier method (cumulative incidence) or accounting for competing risk of death (lifetime risk [LTR]).
  
  
  RESULTS
  Overall, 777 cases of incident dementia (601 AD) occurred in 7901 participants (4333 women) over 136,266 person-years. Whereas cumulative incidences were similar in women and men, LTRs were higher in women older than 85 years of age. LTR of dementia/AD at age 45 was 1 in 5 in women and 1 in 10 in men. Cardiovascular mortality was higher in men with rate ratios decreasing from approximately 6 at 45 to 54 years of age to less than 2 after age 65.
  
  
  CONCLUSIONS
  Selective survival of men with a healthier cardiovascular risk profile and hence lower propensity to dementia might partly explain the higher LTR of dementia/AD in women.
authors.affiliation: Inserm U897 & CIC-EC7; Univ Bordeaux Segalen, Isped (Bordeaux School of Public Health); CHU de Bordeaux.
authors.forename: Geneviève
authors.initials: G
authors.lastname: Chêne
authors.affiliation: Department of Neurology, Boston University School of Medicine, Boston, MA.|Department of Biostatistics, Boston University School of Public Health, Boston, MA.
authors.forename: Alexa
authors.initials: A
authors.lastname: Beiser
authors.affiliation: Department of Neurology, Boston University School of Medicine, Boston, MA.
authors.forename: Rhoda
authors.initials: R
authors.lastname: Au
authors.affiliation: Department of Biostatistics, Boston University School of Public Health, Boston, MA.
authors.forename: Sarah R
authors.initials: SR
authors.lastname: Preis
authors.affiliation: Department of Neurology, Boston University School of Medicine, Boston, MA.
authors.forename: Philip A
authors.initials: PA
authors.lastname: Wolf
authors.affiliation: Inserm U897 & CIC-EC7; Univ Bordeaux Segalen, Isped (Bordeaux School of Public Health); CHU de Bordeaux.
authors.forename: Carole
authors.initials: C
authors.lastname: Dufouil
authors.affiliation: Department of Neurology, Boston University School of Medicine, Boston, MA.
authors.forename: Sudha
authors.initials: S
authors.lastname: Seshadri
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000401:mortality; D003704:Dementia / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D008875:Middle Aged; D011446:Prospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D016019:Survival Analysis
keywords: Alzheimer's disease; Cardiovascular risk profile; Cohort/population-based cohort; Gender; Incidence of dementia; Mortality; Prevention; Selective survival