Table 4.
Hazard ratio (95% CI) of developing ADRD by a history of CVD, stroke, hypertension, and diabetes in women with breast cancer with up to 26 years of follow-up from 1991 to 2016
| Characteristics | Hazard ratio (95% CI)* of developing ADRD by CVD, stroke, hypertension, and diabetes |
||||||
|---|---|---|---|---|---|---|---|
| AD | Vacular | Lewy | FTD | MCI | Others | Total | |
|
| |||||||
| Cardiovascular disease | |||||||
| No | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
| Yes | 1.21 (1.16,1.26) | 1.76 (1.63,1.89) | 0.98 (0.82,1.17) | 0.71 (0.49,1.04) | 0.85 (0.77,0.95) | 1.29 (1.26,1.32) | 1.30 (1.27,1.33) |
| Stroke | |||||||
| No | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
| Yes | 1.32 (1.27,1.37) | 1.43 (1.31,1.55) | 1.54 (1.32,1.79) | 1.25 (0.91,1.72) | 1.79 (1.65,1.95) | 1.49 (1.46,1.53) | 1.50 (1.47,1.54) |
| Hypertension | |||||||
| No | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
| Yes | 0.96 (0.93,0.98) | 0.87 (0.83,0.91) | 1.05 (0.95,1.16) | 1.12 (0.93,1.35) | 1.25 (1.18,1.33) | 1.08 (1.07,1.1) | 1.08 (1.06,1.09) |
| Diabetes | |||||||
| No | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
| Yes | 1.15 (1.11,1.18) | 1.05 (0.98,1.12) | 1.22 (1.09,1.37) | 1.21 (0.98,1.5) | 1.28 (1.2,1.36) | 1.27 (1.24,1.29) | 1.26 (1.24,1.29) |
| Age (years) | |||||||
| 65–69 | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
| 70–74 | 1.94 (1.86,2.02) | 1.83 (1.69,1.98) | 1.67 (1.45,1.92) | 1.21 (0.96,1.54) | 1.42 (1.32,1.54) | 1.62 (1.58,1.66) | 1.61 (1.57,1.64) |
| 75–79 | 3.26 (3.13,3.40) | 2.96 (2.73,3.20) | 2.26 (1.96,2.60) | 1.53 (1.20,1.95) | 1.93 (1.78,2.09) | 2.54 (2.48,2.60) | 2.49 (2.43,2.55) |
| 80–84 | 5.29 (5.07,5.52) | 4.27 (3.93,4.65) | 3.09 (2.64,3.60) | 1.78 (1.35,2.34) | 2.43 (2.22,2.65) | 3.83 (3.73,3.93) | 3.75 (3.65,3.84) |
| 85 or older | 7.42 (7.08,7.78) | 5.42 (4.93,5.96) | 2.96 (2.45,3.57) | 1.56 (1.08,2.24) | 2.81 (2.53,3.12) | 5.63 (5.48,5.79) | 5.50 (5.35,5.65) |
| Race/ethnicity | |||||||
| Whites | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
| Blacks | 1.21 (1.16,1.27) | 1.51 (1.39,1.64) | 0.94 (0.78,1.14) | 0.73 (0.50,1.07) | 0.93 (0.84,1.04) | 1.16 (1.13,1.19) | 1.16 (1.13,1.19) |
| Asians/Pacific Islanders | 0.77 (0.71,0.83) | 0.67 (0.57,0.79) | 0.76 (0.57,1.01) | 0.75 (0.44,1.29) | 0.55 (0.47,0.65) | 0.81 (0.77,0.84) | 0.83 (0.79,0.86) |
| Others | 1.05 (0.97,1.13) | 1.22 (1.07,1.39) | 0.89 (0.66,1.21) | 0.70 (0.37,1.33) | 0.52 (0.43,0.64) | 0.98 (0.93,1.03) | 0.97 (0.93,1.02) |
| Marital status | |||||||
| Married | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
| Unmarried | 1.16 (1.13,1.19) | 1.32 (1.25,1.39) | 0.99 (0.90,1.09) | 1.18 (0.99,1.41) | 1.05 (1,1.11) | 1.21 (1.19,1.23) | 1.20 (1.18,1.22) |
| Unknown | 1.12 (1.06,1.19) | 1.08 (0.96,1.22) | 1.12 (0.90,1.40) | 1.39 (0.94,2.05) | 1.21 (1.06,1.38) | 1.14 (1.10,1.19) | 1.14 (1.10,1.18) |
| AJCC Tumor stage | |||||||
| 0 or I | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
| II | 1.11 (1.07,1.15) | 1.34 (1.25,1.44) | 1.02 (0.89,1.18) | 1.07 (0.83,1.39) | 0.92 (0.85,1.00) | 1.11 (1.09,1.14) | 1.11 (1.09,1.13) |
| III | 1.24 (1.17,1.31) | 1.19 (1.04,1.36) | 1.34 (1.06,1.69) | 1.04 (0.66,1.64) | 0.88 (0.76,1.02) | 1.37 (1.32,1.42) | 1.35 (1.31,1.40) |
| IV | 1.13 (1.03,1.24) | 1.29 (1.05,1.59) | 1.01 (0.66,1.56) | 0.71 (0.29,1.77) | 0.88 (0.70,1.11) | 1.81 (1.73,1.89) | 1.75 (1.67,1.83) |
| Unknown/Missing | 1.41 (1.32,1.50) | 1.67 (1.46,1.91) | 1.30 (1.01,1.68) | 1.24 (0.76,2.03) | 0.79 (0.67,0.93) | 1.41 (1.36,1.47) | 1.41 (1.36,1.47) |
| Tumor size (cm) | |||||||
| <1 | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
| 1–<2 | 1.08 (1.05,1.12) | 1.11 (1.04,1.18) | 0.97 (0.86,1.09) | 1.01 (0.81,1.26) | 0.93 (0.87,0.99) | 1.07 (1.05,1.09) | 1.06 (1.04,1.08) |
| 2–<3 | 1.06 (1.01,1.11) | 1.08 (0.99,1.18) | 1.06 (0.89,1.25) | 0.96 (0.70,1.32) | 0.91 (0.83,1.01) | 1.06 (1.03,1.09) | 1.05 (1.02,1.08) |
| 3–<4 | 1.16 (1.10,1.23) | 0.97 (0.87,1.09) | 1.14 (0.91,1.43) | 0.94 (0.61,1.44) | 0.90 (0.79,1.04) | 1.16 (1.12,1.20) | 1.14 (1.11,1.18) |
| ≥4 | 1.15 (1.10,1.22) | 0.97 (0.87,1.08) | 1.10 (0.90,1.36) | 1.17 (0.80,1.70) | 1.09 (0.97,1.22) | 1.15 (1.12,1.19) | 1.14 (1.11,1.18) |
| Missing | 0.95 (0.89,1.01) | 0.66 (0.57,0.76) | 0.99 (0.77,1.27) | 0.98 (0.61,1.56) | 1.16 (1.01,1.33) | 0.98 (0.94,1.02) | 0.97 (0.93,1.01) |
| Tumor grade | |||||||
| Well-differentiated | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
| Moderately-differentiated | 0.99 (0.95,1.02) | 1.02 (0.96,1.09) | 0.92 (0.82,1.03) | 1.00 (0.81,1.24) | 0.92 (0.86,0.98) | 0.98 (0.96,1.00) | 0.98 (0.97,1.00) |
| Poorly-differentiated | 1.01 (0.97,1.04) | 1.07 (0.99,1.15) | 0.93 (0.81,1.07) | 0.97 (0.75,1.25) | 0.91 (0.84,0.98) | 1.03 (1.01,1.06) | 1.04 (1.02,1.06) |
| Unknown/Missing | 1.03 (0.99,1.08) | 1.20 (1.11,1.30) | 0.82 (0.69,0.97) | 0.77 (0.55,1.06) | 0.78 (0.7,0.86) | 1.03 (1,1.06) | 1.04 (1.01,1.06) |
| Hormone receptor status | |||||||
| Positive | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
| Negative | 1.04 (1.00,1.09) | 0.99 (0.91,1.07) | 1.05 (0.9,1.23) | 0.95 (0.71,1.27) | 1.04 (0.95,1.13) | 1.05 (1.02,1.07) | 1.04 (1.02,1.07) |
| Unknown | 1.11 (1.07,1.15) | 1.38 (1.30,1.47) | 0.92 (0.8,1.05) | 0.84 (0.64,1.10) | 0.74 (0.68,0.81) | 1.09 (1.06,1.11) | 1.09 (1.06,1.11) |
| Chemotherapy | |||||||
| No | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
| Yes Radiotherapy |
0.83 (0.80,0.86) | 0.90 (0.83,0.97) | 0.71 (0.61,0.83) | 0.93 (0.72,1.21) | 1.03 (0.95,1.12) | 0.93 (0.90,0.95) | 0.92 (0.90,0.94) |
| No | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
| Yes | 0.79 (0.77,0.81) | 0.81 (0.77,0.85) | 0.82 (0.74,0.90) | 0.92 (0.77,1.09) | 1.03 (0.97,1.08) | 0.81 (0.80,0.82) | 0.81 (0.80,0.82) |
| Comorbidity Scores | |||||||
| 0 | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
| 1 | 1.04 (1.01,1.08) | 0.91 (0.85,0.98) | 1.10 (0.97,1.24) | 1.16 (0.92,1.46) | 1.34 (1.25,1.43) | 1.20 (1.18,1.22) | 1.20 (1.17,1.22) |
| ≥2 | 1.15 (1.07,1.22) | 1.14 (0.99,1.31) | 1.23 (0.95,1.60) | 1.49 (0.93,2.39) | 1.32 (1.14,1.52) | 1.45 (1.40,1.50) | 1.45 (1.4,1.5) |
| SEER Areas | |||||||
| Connecticut | 1.14 (1.09,1.19) | 2.11 (1.96,2.27) | 0.75 (0.62,0.90) | 1.13 (0.83,1.52) | 0.67 (0.6,0.74) | 1.05 (1.02,1.08) | 1.05 (1.02,1.08) |
| Detroit | 1.38 (1.32,1.43) | 1.68 (1.55,1.81) | 0.83 (0.70,0.99) | 0.86 (0.61,1.20) | 0.53 (0.47,0.59) | 1.13 (1.10,1.16) | 1.11 (1.08,1.14) |
| Hawaii | 1.24 (1.12,1.37) | 1.98 (1.67,2.36) | 0.61 (0.38,0.99) | 0.48 (0.17,1.33) | 1.09 (0.88,1.35) | 1.15 (1.08,1.23) | 1.15 (1.08,1.22) |
| Iowa | 0.85 (0.81,0.89) | 0.91 (0.82,1.00) | 0.66 (0.55,0.80) | 0.75 (0.53,1.07) | 0.47 (0.42,0.53) | 0.90 (0.87,0.92) | 0.87 (0.84,0.89) |
| New Mexico | 0.95 (0.88,1.03) | 1.05 (0.91,1.23) | 0.94 (0.71,1.25) | 0.83 (0.47,1.47) | 0.60 (0.50,0.72) | 1.08 (1.03,1.13) | 1.04 (1.00,1.09) |
| Seattle | 0.82 (0.78,0.87) | 0.97 (0.88,1.08) | 0.52 (0.41,0.66) | 0.63 (0.42,0.95) | 0.47 (0.41,0.53) | 0.77 (0.75,0.80) | 0.78 (0.75,0.80) |
| Utah | 0.85 (0.78,0.92) | 0.99 (0.85,1.15) | 0.66 (0.48,0.91) | 0.47 (0.23,0.96) | 0.50 (0.41,0.60) | 0.92 (0.88,0.97) | 0.91 (0.87,0.95) |
| Georgia | 1.17 (1.11,1.22) | 0.59 (0.52,0.67) | 1.05 (0.87,1.25) | 1.08 (0.77,1.51) | 0.70 (0.63,0.78) | 0.97 (0.95,1.00) | 0.97 (0.94,1.00) |
| Kentucky | 1.29 (1.23,1.36) | 0.93 (0.82,1.05) | 1.14 (0.94,1.38) | 1.12 (0.78,1.61) | 0.52 (0.46,0.60) | 1.24 (1.20,1.28) | 1.18 (1.15,1.22) |
| Louisiana | 1.11 (1.05,1.18) | 0.63 (0.54,0.73) | 0.97 (0.77,1.21) | 0.91 (0.59,1.41) | 0.64 (0.56,0.74) | 0.94 (0.91,0.97) | 0.94 (0.90,0.97) |
| New Jersey | 1.17 (1.13,1.22) | 1.12 (1.04,1.22) | 1.04 (0.90,1.21) | 1.27 (0.98,1.65) | 0.86 (0.79,0.93) | 0.98 (0.95,1.00) | 0.98 (0.96,1.01) |
| California | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
ADRD, Alzheimer’s disease and related dementias; AD, Alzheimer’s disease; Vascular, vascular dementia; Lewy, dementia with Lewy bodies; FTD, frontotemporal degeneration and dementias; MCI, mild cognitive impairment; others, other dementias; total, any of above ADRD; CVD, cardiovascular diseases.
*
Hazard ratios were adjusted for cardiovascular disease, stroke, hypertension, diabetes, age, race/ethnicity, marital status, tumor stage, tumor size, tumor grade, hormone receptor status, chemotherapy, radiotherapy, comorbidity scores, and SEER areas.