Original ArticlesVascular Risk Factors for Incident Alzheimer Disease and Vascular Dementia: The Cache County StudyHayden, Kathleen M. PhD*; Zandi, Peter P. PhD†; Lyketsos, Constantine G. MD, MHS† ‡; Khachaturian, Ara S. PhD§; Bastian, Lori A. MD∥; Charoonruk, Gene PhD¶; Tschanz, JoAnn T. PhD♯ **; Norton, Maria C. PhD♯ ** ††; Pieper, Carl F. DrPH‡‡; Munger, Ron G. PhD¶ **; Breitner, John C.S. MD, MPH§§; Welsh-Bohmer, Kathleen A. PhD∥∥For the Cache County InvestigatorsAuthor Information *Department of Medicine, Division of Neurology ‡‡Center for the Study of Aging and Human Development and Department of Biometry and Bioinformatics ∥Department of Medicine, Duke University Medical Center and Department of Veterans Affairs Medical Center ∥∥Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC †Department of Mental Health, The Johns Hopkins Bloomberg School of Public Health ‡Department of Psychiatry, Division of Geriatric Psychiatry and Neuropsychiatry, The Johns Hopkins University School of Medicine, Baltimore, MD §Khachaturian and Associates, Inc, Potomac, MD ¶Department of Nutrition and Food Sciences ♯Department of Psychology **Center for Epidemiologic Studies ††Department of Family Consumer and Human Development, Utah State University, Logan, UT §§VA Puget Sound Health Care System, and Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA Supported by NIH grant AG-11380 and the work of Dr Hayden by T32-MH14592 and T32-AG000029. Reprints: Kathleen M. Hayden, PhD, Joseph and Kathleen Bryan Alzheimer's Disease Research Center, 2200 W Main St, Suite A230, Durham, NC 27705 (e-mail: [email protected]). Received for publication July 28, 2005; accepted February 20, 2006 Alzheimer Disease & Associated Disorders: April-June 2006 - Volume 20 - Issue 2 - p 93-100 doi: 10.1097/01.wad.0000213814.43047.86 Buy Metrics Abstract Vascular risk factors for Alzheimer disease (AD) and vascular dementia (VaD) have been evaluated; however, few studies have compared risks by dementia subtypes and sex. We evaluated relationships between cardiovascular risk factors (hypertension, high cholesterol, diabetes mellitus, and obesity), events (stroke, coronary artery bypass graft surgery, and myocardial infarction), and subsequent risk of AD and VaD by sex in a community-based cohort of 3264 Cache County residents aged 65 or older. Cardiovascular history was ascertained by self-report or proxy-report in detailed interviews. AD and VaD were diagnosed using standard criteria. Estimates from discrete-time survival models showed no association between self-reported history of hypertension and high cholesterol and AD after adjustments. Hypertension increased the risk of VaD [adjusted hazard ratio (aHR) 2.42, 95% confidence interval (CI) 0.95-7.44]. Obesity increased the risk of AD in females (aHR 2.23, 95% CI 1.09-4.30) but not males. Diabetes increased the risk of VaD in females after adjustments (aHR 3.33, 95% CI 1.03-9.78) but not males. The risk of VaD after stroke was increased in females (aHR 16.90, 95% CI 5.58-49.03) and males (aHR 10.95, 95% CI 2.48-44.78). The results indicate that vascular factors increase risks for AD and VaD differentially by sex. Future studies should focus on specific causal pathways for each of these factors with regard to sex to determine if sex differences in the prevalence of vascular factors have an influence on sex differences in dementia risk. © 2006 Lippincott Williams & Wilkins, Inc.