Sex difference in the relation between marital status and dementia risk in two population-based cohorts

Jenna Najar, Jeremiah A. Aakre, Maria Vassilaki, Hanna Wetterberg, Lina Rydén, Anna Zettergren, Ingmar Skoog, Clifford R. Jack, David S. Knopman, Ronald C. Petersen, Silke Kern, Michelle M. Mielke

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The modifying effect of sex on the relation between marital status and dementia has yet to be determined. Objective: To examine if sex modifies the association between marital status and incident dementia. Methods: Population-based samples from the Mayo Clinic Study of Aging (MCSA, N = 3,471) and the Gothenburg H70 Birth Cohort Study (H70-study, N = 913) were used. A multiplicative interaction term was used to analyze the modifying effect of sex on the relation between marital status (married versus not married) and incident dementia using Cox regression models. Further, risk of dementia by marital status was also evaluated in models separated by sex. Results: In the MCSA, there was an interaction between marital status and sex in relation to dementia (p = 0.015). In contrast, in the H70-study, no significant interaction was observed (p = 0.28). Nevertheless, in both studies, not married men had increased risk of dementia compared to married men in models adjusted for age, education, and number of children (H70-study: 1.99; 1.06-3.76, MCSA: 1.43; 1.08-1.89). Associations remained similar after additional adjustment for depression, BMI, hypertension, dyslipidemia, and diabetes mellitus (H70-study: 2.00; 1.05-3.82, MCSA: 1.32; 0.99-1.76). Further, no significant association was observed between marital status and dementia in women (H70-study: 1.24; 0.82-1.89, MCSA: 0.82; 0.64-1.04). Conclusion: Sex had a modifying effect on the association between marital status and incident dementia. In analyses separated by sex, not married men had an increased risk of dementia compared to married men, while no significant association was observed between marital status and risk of dementia in women.

Original languageEnglish (US)
Pages (from-to)1269-1279
Number of pages11
JournalJournal of Alzheimer's Disease
Volume83
Issue number3
DOIs
StatePublished - 2021

Keywords

  • Dementia
  • epidemiology
  • marital status
  • risk factors
  • sex differences

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Psychology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health

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