Gender and incidence of dementia in the Framingham Heart Study from mid-adult life

Geneviève Chêne, Alexa Beiser, Rhoda Au, Sarah R. Preis, Philip A. Wolf, Carole Dufouil, Sudha Seshadri

Research output: Contribution to journalArticlepeer-review

199 Scopus citations


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. Conclusion 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.

Original languageEnglish (US)
Pages (from-to)310-320
Number of pages11
JournalAlzheimer's and Dementia
Issue number3
StatePublished - Mar 1 2015
Externally publishedYes


  • Alzheimer's disease
  • Cardiovascular risk profile
  • Cohort/population-based cohort
  • Gender
  • Incidence of dementia
  • Mortality
  • Prevention
  • Selective survival

ASJC Scopus subject areas

  • Epidemiology
  • Health Policy
  • Developmental Neuroscience
  • Clinical Neurology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health
  • Cellular and Molecular Neuroscience


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