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% Confidence Interval) | |||
|---|---|---|---|---|---|---|---|
| Model 1 | Model 2 | Model 3 | |||||
| (a) Alzheimer’s Disease (AD) | |||||||
| Women | 4,561 | 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 | 2,803 | 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 | 1,002 | 2,832 | 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 | 1,454 | 2,918 | 187,200 | 6.60 | 0.94 (0.87-1.02) | 0.94 (0.87-1.02) | 1.06 (0.97-1.15) |
| Latino | 769 | 2,022 | 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 | 1,001 | 3,191 | 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 | 1,989 | 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 | 3,962 | 147,930 | 5.55 | 0.89 (0.81-0.98) | 0.90 (0.81-1.00) | 0.99 (0.90-1.10) |
| Latino | 553 | 2,535 | 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 | 3,449 | 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) Alzheimer’s Disease and Related Dementia (ADRD) | |||||||
| Women | 9,792 | 9,406 | 574,019 | 17.01 | 1.03 (1.00-1.11) | 1.01 (0.98-1.04) | 1.15 (1.12-1.19) |
| Men | 6,618 | 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 | 2,175 | 2,061 | 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 | 2,994 | 2,192 | 181,323 | 14.76 | 0.89 (0.84-0.94) | 0.87 (0.82-0.92) | 0.97 (0.92-1.03) |
| Latino | 1,609 | 1,609 | 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 | 2,214 | 2,473 | 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 | 1,005 | 1,557 | 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 | 2,151 | 3,114 | 144,076 | 13.84 | 0.87 (0.81-0.93) | 0.85 (0.80-0.91) | 0.94 (0.88-1.01) |
| Latino | 1,250 | 2,066 | 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 | 1,629 | 2,807 | 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 | ||||
ASDIR (age-standardized diagnostic incidence rate per 1000 person-years)
Competing events refer to deaths due to other (non-ADRD) causes among individuals who have not been diagnosed for AD or ADRD.
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.