Risk of Alzheimer's disease and related dementia by sex and race/ethnicity: The Multiethnic Cohort Study

Introduction Data are limited for comparison of sex- and race/ethnicity-specific risks of Alzheimer's disease and related dementia (ADRD). Methods In the population-based Multiethnic Cohort, we estimated the age-standardized diagnostic incidence rate (ASDIR) and relative risk of late-onset ADRD (n = 16,410) among 105,796 participants based on Medicare claims (1999-2014) by sex and race/ethnicity. Results The ASDIR for ADRD was higher for women (17.0 per 1000 person-years) than for men (15.3) and varied across African Americans (22.9 in women, 21.5 in men), Native Hawaiians (19.3, 19.4), Latinos (16.8, 14.7), Whites (16.4, 15.5), Japanese Americans (14.8, 13.8), and Filipinos (12.5, 9.7). Similar risk patterns were observed for AD. Adjustment for education and cardiometabolic diseases attenuated the differences. Accounting for deaths from competing causes increased the sex difference, while reducing the racial/ethnic differences. Less racial/ethnic disparity was detected among apolipoprotein E (APOE) e4 carriers. Discussion More research is needed to understand the sex and racial/ethnic differences in ADRD.

Automated summary

Limited data is available for comparing sex- and race/ethnicity-specific risks of Alzheimer's disease and related dementia. The study found differences in risk of ADRD among different sexes and race/ethnicities, which were attenuated by adjusting for education and cardiometabolic diseases. More research is needed to further understand these differences.