Sex Difference in the Association between Prior Fracture and Subsequent Risk of Incident Dementia: A Longitudinal Cohort Study

D. Gao, W. Rong, C. Li, J. Liang, Y. Wang, Y. Pan, W. Zhang, Fanfan Zheng, Wuxiang Xie
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Abstract

Background

A history of fracture has been associated with increased risk of dementia; however, it is uncertain whether sex difference exists in the association between prior fracture and subsequent risk of incident dementia.

Objectives

To investigate whether sex modified the relationship between prior fracture and subsequent risk of dementia.

Design

Prospective cohort study.

Setting

UK Biobank.

Participants

496,331 participants (54.6% women) free of dementia at baseline.

Measurements

History of fracture was self-reported via touchscreen questionnaires at baseline. The primary outcome was all-cause dementia.

Results

Both any fracture and fragility fracture were significantly associated with an increased risk of subsequent all-cause dementia in men (adjusted hazard ratio (HR): 1.28; 95% confidence interval (CI): 1.14–1.43; adjusted HR: 1.48; 95% CI: 1.18–1.87, respectively), but not in women (adjusted HR: 1.04; 95% CI 0.95–1.15; adjusted HR: 1.01; 95% CI: 0.87–1.18, respectively); and these sex-differences were significant (P interaction = 0.006; P interaction = 0.007, respectively). The sex differences in the impacts of different fracture sites (including upper limb, lower limb, spine, and multiple sites) were consistent on all-cause dementia.

Conclusions

This study demonstrated that prior fracture was associated with an increased risk of dementia in men but not in women, and the sex difference was significant. Previous fracture may be an important marker for identifying subsequent dementia in middle-aged and older men.

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既往骨折与后续痴呆症发病风险之间的性别差异:纵向队列研究
背景骨折史与痴呆症风险增加有关;但是,目前还不确定在既往骨折史与随后的痴呆症发病风险之间是否存在性别差异。研究目的探讨性别是否会改变既往骨折史与随后的痴呆症风险之间的关系。结果任何骨折和脆性骨折均与男性后续全因痴呆风险的增加显著相关(调整后危险比 (HR):1.28;95% 置信区间 (CI):1.14-1.43;调整后危险比 (HR):1.28;95% 置信区间 (CI):1.14-1.43)。43;调整HR:1.48;95% CI:1.18-1.87),而女性则不然(调整HR:1.04;95% CI:0.95-1.15;调整HR:1.01;95% CI:0.87-1.18);这些性别差异具有显著性(P交互作用=0.006;P交互作用=0.007)。不同骨折部位(包括上肢、下肢、脊柱和多个部位)的性别差异对全因痴呆症的影响是一致的。结论这项研究表明,既往骨折与男性痴呆症风险增加有关,但与女性无关,且性别差异显著。既往骨折可能是识别中老年男性继发性痴呆的重要标志。
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来源期刊
The Journal of Prevention of Alzheimer's Disease
The Journal of Prevention of Alzheimer's Disease Medicine-Psychiatry and Mental Health
CiteScore
9.20
自引率
0.00%
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0
期刊介绍: The JPAD Journal of Prevention of Alzheimer’Disease will publish reviews, original research articles and short reports to improve our knowledge in the field of Alzheimer prevention including: neurosciences, biomarkers, imaging, epidemiology, public health, physical cognitive exercise, nutrition, risk and protective factors, drug development, trials design, and heath economic outcomes.JPAD will publish also the meeting abstracts from Clinical Trial on Alzheimer Disease (CTAD) and will be distributed both in paper and online version worldwide.We hope that JPAD with your contribution will play a role in the development of Alzheimer prevention.
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