TABLE 2.
Diagnostic incidence of AD and ADRD by sex and race/ethnicity in the Multiethnic Cohort Study (1999‐2014; N = 105,796)
| Events | Competing events* | Person‐years | ASDIR | Hazard Ratio (95% CI) | |||
|---|---|---|---|---|---|---|---|
| Model 1 | Model 2 | Model 3 | |||||
| (a) AD | |||||||
| Women | 4561 | 12,266 | 592,678 | 7.32 | 1.17 (1.11–1.23) | 1.12 (1.07–1.18) | 1.27 (1.21–1.33) |
| Men | 2803 | 13,389 | 454,877 | 6.08 | 1.00 (ref) | 1.00 (ref) | 1.00 (ref) |
| P for sex (all races combined) | <0.0001 | <0.0001 | <0.0001 | ||||
| Women | |||||||
| African American | 1002 | 2832 | 88,315 | 9.54 | 1.37 (1.26–1.50) | 1.28 (1.17–1.40) | 1.25 (1.14–1.37) |
| Filipino | 111 | 395 | 25,420 | 4.58 | 0.71 (0.58–0.86) | 0.72 (0.59–0.87) | 0.77 (0.63–0.93) |
| Japanese American | 1454 | 2918 | 187,200 | 6.60 | 0.94 (0.87–1.02) | 0.94 (0.87–1.02) | 1.06 (0.97–1.15) |
| Latino | 769 | 2022 | 114,723 | 7.76 | 1.15 (1.04–1.26) | 1.05 (0.95–1.17) | 1.11 (1.00–1.24) |
| Native Hawaiian | 224 | 908 | 36,786 | 7.65 | 1.16 (1.00–1.34) | 1.10 (0.95–1.28) | 1.07 (0.92–1.24) |
| White | 1001 | 3191 | 140,234 | 6.85 | 1.00 (ref) | 1.00 (ref) | 1.00 (ref) |
| P for race/ethnicity | < 0.0001 | < 0.0001 | < 0.0001 | ||||
| Men | |||||||
| African American | 402 | 1989 | 44,755 | 7.85 | 1.27 (1.12–1.43) | 1.26 (1.10–1.43) | 1.19 (1.05–1.35) |
| Filipino | 80 | 528 | 22,211 | 3.56 | 0.60 (0.47–0.75) | 0.63 (0.50–0.80) | 0.69 (0.55–0.87) |
| Japanese American | 927 | 3962 | 147,930 | 5.55 | 0.89 (0.81–0.98) | 0.90 (0.81–1.00) | 0.99 (0.90–1.10) |
| Latino | 553 | 2535 | 99,739 | 6.19 | 1.04 (0.93–1.16) | 1.00 (0.88–1.13) | 1.08 (0.96–1.22) |
| Native Hawaiian | 160 | 926 | 26,555 | 7.99 | 1.35 (1.13–1.60) | 1.27 (1.06–1.52) | 1.22 (1.02–1.46) |
| White | 681 | 3449 | 113,687 | 6.07 | 1.00 (ref) | 1.00 (ref) | 1.00 (ref) |
| P for race/ethnicity | <0.0001 | <0.0001 | <0.0001 | ||||
| P for race/ethnicity by sex | 0.26 | 0.46 | 0.52 | ||||
| (b) ADRD | |||||||
| Women | 9792 | 9406 | 574,019 | 17.01 | 1.03 (1.00–1.11) | 1.01 (0.98–1.04) | 1.15 (1.12–1.19) |
| Men | 6618 | 10,769 | 443,287 | 15.33 | 1.00 (ref) | 1.00 (ref) | 1.00 (ref) |
| P for sex (all races combined) | <0.0001 | 0.49 | <0.0001 | ||||
| Women | |||||||
| African American | 2175 | 2061 | 84,398 | 22.92 | 1.39 (1.31–1.47) | 1.24 (1.16–1.32) | 1.22 (1.15–1.30) |
| Filipino | 278 | 322 | 24,783 | 12.53 | 0.79 (0.70–0.89) | 0.79 (0.69–0.89) | 0.84 (0.74–0.95) |
| Japanese American | 2994 | 2192 | 181,323 | 14.76 | 0.89 (0.84–0.94) | 0.87 (0.82–0.92) | 0.97 (0.92–1.03) |
| Latino | 1609 | 1609 | 111,684 | 16.79 | 1.06 (0.99–1.13) | 0.93 (0.87–1.00) | 0.99 (0.92–1.06) |
| Native Hawaiian | 522 | 749 | 35,778 | 19.33 | 1.21 (1.10–1.33) | 1.13 (1.03–1.25) | 1.06 (0.96–1.17) |
| White | 2214 | 2473 | 136,053 | 16.38 | 1.00 (ref) | 1.00 (ref) | 1.00 (ref) |
| P for race/ethnicity | <0.0001 | <0.0001 | <0.0001 | ||||
| Men | |||||||
| African American | 1005 | 1557 | 43,054 | 21.51 | 1.37 (1.26–1.48) | 1.31 (1.21–1.42) | 1.25 (1.15–1.35) |
| Filipino | 208 | 440 | 21,859 | 9.72 | 0.63 (0.54–0.72) | 0.64 (0.55–0.74) | 0.71 (0.62–0.83) |
| Japanese American | 2151 | 3114 | 144,076 | 13.84 | 0.87 (0.81–0.93) | 0.85 (0.80–0.91) | 0.94 (0.88–1.01) |
| Latino | 1250 | 2066 | 97,610 | 14.71 | 0.96 (0.89–1.03) | 0.87 (0.81–0.95) | 0.95 (0.88–1.03) |
| Native Hawaiian | 375 | 785 | 25,870 | 19.44 | 1.30 (1.16–1.46) | 1.19 (1.06–1.33) | 1.12 (0.99–1.25) |
| White | 1629 | 2807 | 110,818 | 15.50 | 1.00 (ref) | 1.00 (ref) | 1.00 (ref) |
| P for race/ethnicity | <0.0001 | <0.0001 | <0.0001 | ||||
| P for race/ethnicity by sex | 0.045 | 0.055 | 0.39 | ||||
Note: Model 1: Cox proportional hazards regression model adjusted for age at cohort entry and age at Medicare follow‐up start.
Model 2: includes Model 1 adjustments + education, history of heart disease, stroke, diabetes or hypertension at cohort baseline, and mean annual Medicare usage (in‐patient, out‐patient) over follow‐up.
Model 3: includes Model 2 adjustments in a competing risk model accounting for deaths due to other causes.
P for race/ethnicity for the overall racial/ethnic difference was obtained from the Wald chi‐square test for the main effect of race/ethnicity in the sex‐stratified Cox regression model for AD or ADRD. P for race/ethnicity by sex for the heterogeneity of the racial/ethnic differences between women and men was obtained based on the interaction term between sex and race/ethnicity in the combined Cox regression model for AD or ADRD.
ASDIR (age‐standardized diagnostic incidence rate per 1000 person‐years).
Abbreviations: AD, Alzheimer's disease; ADRD, Alzheimer's disease and related dementia; CI, confidence interval.
Competing events refer to deaths due to other (non‐ADRD) causes among individuals who have not been diagnosed for AD or ADRD.