Objective: To study the difference in risk for dementing diseases between m
en and women. Background: Previous studies suggest women have a higher risk
for dementia than men. However, these studies include small sample sizes,
particularly in the older age groups, when the incidence of dementia is hig
hest. Methods: Pealed analysis of four population-based prospective cohort
studies was performed. The sample included persons 65 years and alder, 528
incident cases of dementia, and 28,768 person-years of follow-up. Incident
cases were identified in a two-stage procedure in which the total cohort wa
s screened for cognitive impairment, and screen positives underwent detaile
d diagnostic assessment. Dementia and main subtypes of AD and vascular deme
ntia were diagnosed according to internationally accepted guidelines. Sex-
and age-specific incidence rates, and relative and cumulative risks for tot
al dementia, AD, and vascular dementia were calculated using log linear ana
lysis and Poisson regression. Results: There were significant gender differ
ences in the incidence of AD after age 85 years. At 90 years of age, the ra
te was 81.7 (95% CI, 63.8 to 104.7) in women and 24.0 (95% CI, 10.3 to 55.6
) in men. There were no gender differences in rates or risk for vascular de
mentia. The cumulative risk for 65-year-old women to develop AD at the age
of 95 years was 0.22 compared with 0.09 for men. The cumulative risk for de
veloping vascular dementia at the age of 95 years was similar for men and w
omen (0.04). Conclusion: Compared with men, women have an increased risk fo
r AD. There are no gender differences in risk for vascular dementia.