title: Type 2 Diabetes as a Risk Factor for Dementia in Women Compared With Men: A Pooled Analysis of 2.3 Million People Comprising More Than 100,000 Cases of Dementia.
abstract: OBJECTIVE
  Type 2 diabetes confers a greater excess risk of cardiovascular disease in women than in men. Diabetes is also a risk factor for dementia, but whether the association is similar in women and men remains unknown. We performed a meta-analysis of unpublished data to estimate the sex-specific relationship between women and men with diabetes with incident dementia.
  
  
  METHODS
  A systematic search identified studies published prior to November 2014 that had reported on the prospective association between diabetes and dementia. Study authors contributed unpublished sex-specific relative risks (RRs) and 95% CIs on the association between diabetes and all dementia and its subtypes. Sex-specific RRs and the women-to-men ratio of RRs (RRRs) were pooled using random-effects meta-analyses.
  
  
  RESULTS
  Study-level data from 14 studies, 2,310,330 individuals, and 102,174 dementia case patients were included. In multiple-adjusted analyses, diabetes was associated with a 60% increased risk of any dementia in both sexes (women: pooled RR 1.62 [95% CI 1.45-1.80]; men: pooled RR 1.58 [95% CI 1.38-1.81]). The diabetes-associated RRs for vascular dementia were 2.34 (95% CI 1.86-2.94) in women and 1.73 (95% CI 1.61-1.85) in men, and for nonvascular dementia, the RRs were 1.53 (95% CI 1.35-1.73) in women and 1.49 (95% CI 1.31-1.69) in men. Overall, women with diabetes had a 19% greater risk for the development of vascular dementia than men (multiple-adjusted RRR 1.19 [95% CI 1.08-1.30]; P < 0.001).
  
  
  CONCLUSIONS
  Individuals with type 2 diabetes are at ∼60% greater risk for the development of dementia compared with those without diabetes. For vascular dementia, but not for nonvascular dementia, the additional risk is greater in women.
authors.affiliation: Alfred Health, Melbourne, Australia.
authors.forename: Saion
authors.initials: S
authors.lastname: Chatterjee
authors.affiliation: The George Institute for Global Health, Nuffield Department of Population Health, University of Oxford, Oxford, U.K.
authors.forename: Sanne A E
authors.initials: SA
authors.lastname: Peters
authors.affiliation: The George Institute for Global Health, Nuffield Department of Population Health, University of Oxford, Oxford, U.K. The George Institute for Global Health, University of Sydney, Sydney, Australia Department of Epidemiology, Johns Hopkins University, Baltimore, MD.
authors.forename: Mark
authors.initials: M
authors.lastname: Woodward
authors.affiliation: Department of Population Studies, El Colegio de la Frontera Norte, Tijuana, Baja California, México.
authors.forename: Silvia
authors.initials: S
authors.lastname: Mejia Arango
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, U.K. Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, Edinburgh, U.K. Alzheimer Scotland Dementia Research Centre, The University of Edinburgh, Edinburgh, U.K.
authors.forename: G David
authors.initials: GD
authors.lastname: Batty
authors.affiliation: Section of Care of the Elderly, Faculty of Medicine, Imperial College London, London, U.K.
authors.forename: Nigel
authors.initials: N
authors.lastname: Beckett
authors.affiliation: Department of Biostatistics, Boston University School of Public Health, Boston, MA.
authors.forename: Alexa
authors.initials: A
authors.lastname: Beiser
authors.affiliation: Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL.
authors.forename: Amy R
authors.initials: AR
authors.lastname: Borenstein
authors.affiliation: Department of Medicine, University of Washington, Seattle, WA.
authors.forename: Paul K
authors.initials: PK
authors.lastname: Crane
authors.affiliation: Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA.
authors.forename: Mary
authors.initials: M
authors.lastname: Haan
authors.affiliation: Department of Psychology, Gothenburg University, Gothenburg, Sweden.
authors.forename: Linda B
authors.initials: LB
authors.lastname: Hassing
authors.affiliation: Department of Social Sciences & Health Policy, Wake Forest School of Medicine, Winston-Salem, NC.
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Hayden
authors.affiliation: Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kiyohara
authors.affiliation: Group Health Research Institute, Seattle, WA.
authors.forename: Eric B
authors.initials: EB
authors.lastname: Larson
authors.affiliation: Department and Graduate Institute of Public Health, College of Medicine, National Cheng Kung University, Tainan, Tawian.
authors.forename: Chung-Yi
authors.initials: CY
authors.lastname: Li
authors.affiliation: Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Ninomiya
authors.affiliation: Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Ohara
authors.affiliation: Section of Care of the Elderly, Faculty of Medicine, Imperial College London, London, U.K.
authors.forename: Ruth
authors.initials: R
authors.lastname: Peters
authors.affiliation: Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, Edinburgh, U.K. Alzheimer Scotland Dementia Research Centre, The University of Edinburgh, Edinburgh, U.K. Scottish Dementia Clinical Research Network, NHS Scotland, Edinburgh, U.K. Division of Psychiatry, The University of Edinburgh, Edinburgh, U.K.
authors.forename: Tom C
authors.initials: TC
authors.lastname: Russ
authors.affiliation: Department of Neurology, Boston University School of Medicine, Boston, MA.
authors.forename: Sudha
authors.initials: S
authors.lastname: Seshadri
authors.affiliation: Norwegian Institute of Public Health, Oslo, Norway.
authors.forename: Bjørn H
authors.initials: BH
authors.lastname: Strand
authors.affiliation: Group Health Research Institute, Seattle, WA.
authors.forename: Rod
authors.initials: R
authors.lastname: Walker
authors.affiliation: Aging Research Centre, Department of Neurobiology, Care Sciences and Society, Karolinska Institute and Stockholm University, Stockholm, Sweden School of Public Health, Tianjin Medical University, Tianjin, China.
authors.forename: Weili
authors.initials: W
authors.lastname: Xu
authors.affiliation: The George Institute for Global Health, University of Sydney, Sydney, Australia School of Public Health, Curtin University, Perth, Australia rachel.huxley@curtin.edu.au.
authors.forename: Rachel R
authors.initials: RR
authors.lastname: Huxley
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000453:epidemiology*; D015140:Dementia, Vascular; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors