Table 5.
Hazard ratio (95% CI) of developing ADRD by a history of combination of risk factors (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 | Vascular | Lewy | FTD | MCI | Others | Total | |
|
| |||||||
| Status of 4 risk factors (cardiovascular disease, stroke, hypertension, and diabetes) | |||||||
| None | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
| 1 of 4 risk factors | 1.00 (0.97,1.03) | 1.02 (0.97,1.08) | 1.12 (1.00,1.24) | 1.25 (1.02,1.52) | 1.24 (1.17,1.33) | 1.14 (1.12,1.16) | 1.14 (1.12,1.16) |
| 2 of 4 risk factors | 1.16 (1.12,1.20) | 1.18 (1.11,1.27) | 1.31 (1.14,1.49) | 1.31 (1.02,1.68) | 1.69 (1.57,1.82) | 1.46 (1.43,1.49) | 1.46 (1.43,1.49) |
| 3 of 4 risk factors | 1.40 (1.33,1.48) | 1.39 (1.24,1.57) | 1.41 (1.11,1.77) | 1.10 (0.68,1.79) | 1.93 (1.71,2.18) | 1.91 (1.85,1.97) | 1.90 (1.84,1.96) |
| 4 of 4 risk factors | 1.60 (1.40,1.84) | 1.81 (1.34,2.44) | 3.21 (2.08,4.95) | 1.58 (0.50,5.00) | 2.35 (1.74,3.18) | 2.45 (2.28,2.64) | 2.47 (2.30,2.66) |
| Age | |||||||
| 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) | 1.82 (1.69,1.97) | 1.67 (1.44,1.92) | 1.21 (0.95,1.53) | 1.42 (1.32,1.54) | 1.62 (1.58,1.66) | 1.60 (1.57,1.64) |
| 75–79 | 3.26 (3.12,3.40) | 2.96 (2.74,3.20) | 2.25 (1.95,2.59) | 1.51 (1.18,1.92) | 1.93 (1.78,2.08) | 2.53 (2.47,2.60) | 2.49 (2.43,2.54) |
| 80–84 | 5.29 (5.06,5.52) | 4.29 (3.95,4.67) | 3.08 (2.64,3.59) | 1.75 (1.33,2.30) | 2.43 (2.23,2.65) | 3.83 (3.73,3.93) | 3.74 (3.65,3.84) |
| 85 or older | 7.44 (7.10,7.80) | 5.56 (5.06,6.11) | 2.95 (2.44,3.56) | 1.51 (1.05,2.17) | 2.81 (2.53,3.11) | 5.64 (5.49,5.80) | 5.51 (5.37,5.66) |
| 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 | 1.20 (1.15,1.26) | 1.48 (1.36,1.61) | 0.94 (0.78,1.13) | 0.74 (0.5,1.08) | 0.92 (0.83,1.03) | 1.15 (1.11,1.18) | 1.15 (1.12,1.18) |
| Asians/Pacific Islanders | 0.76 (0.71,0.82) | 0.65 (0.55,0.76) | 0.76 (0.57,1.01) | 0.76 (0.44,1.30) | 0.55 (0.47,0.65) | 0.80 (0.76,0.84) | 0.82 (0.78,0.85) |
| Others | 1.05 (0.97,1.13) | 1.21 (1.06,1.38) | 0.89 (0.66,1.21) | 0.70 (0.37,1.33) | 0.52 (0.42,0.64) | 0.97 (0.93,1.02) | 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 (1.26,1.39) | 0.99 (0.90,1.09) | 1.18 (0.99,1.41) | 1.05 (0.99,1.11) | 1.21 (1.19,1.23) | 1.20 (1.18,1.22) |
| Unknown | 1.12 (1.06,1.19) | 1.08 (0.95,1.22) | 1.13 (0.91,1.40) | 1.40 (0.95,2.06) | 1.22 (1.07,1.38) | 1.14 (1.10,1.19) | 1.14 (1.11,1.18) |
| 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) | 1.35 (1.26,1.45) | 1.02 (0.89,1.17) | 1.07 (0.83,1.38) | 0.91 (0.84,0.99) | 1.11 (1.09,1.14) | 1.11 (1.09,1.14) |
| III | 1.24 (1.17,1.32) | 1.20 (1.05,1.37) | 1.33 (1.05,1.69) | 1.04 (0.66,1.64) | 0.88 (0.76,1.01) | 1.37 (1.33,1.42) | 1.36 (1.31,1.40) |
| IV | 1.13 (1.03,1.24) | 1.32 (1.07,1.62) | 1.01 (0.66,1.56) | 0.71 (0.29,1.77) | 0.87 (0.69,1.10) | 1.82 (1.74,1.90) | 1.76 (1.68,1.83) |
| Unknown/Missing | 1.41 (1.33,1.50) | 1.70 (1.49,1.94) | 1.29 (1.00,1.67) | 1.23 (0.75,2.02) | 0.79 (0.67,0.93) | 1.42 (1.37,1.47) | 1.42 (1.37,1.47) |
| 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 (1.04,1.09) |
| 2–<3 | 1.06 (1.01,1.11) | 1.09 (1.00,1.19) | 1.06 (0.89,1.25) | 0.96 (0.70,1.32) | 0.92 (0.83,1.01) | 1.06 (1.03,1.09) | 1.05 (1.02,1.08) |
| 3–≤4 | 1.17 (1.10,1.23) | 0.98 (0.87,1.10) | 1.14 (0.91,1.43) | 0.94 (0.61,1.45) | 0.90 (0.79,1.04) | 1.16 (1.12,1.20) | 1.15 (1.11,1.19) |
| ≥4 | 1.16 (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) | 1.15 (1.11,1.18) |
| Missing | 0.95 (0.89,1.01) | 0.65 (0.57,0.75) | 0.99 (0.77,1.27) | 0.98 (0.61,1.57) | 1.17 (1.01,1.34) | 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 (0.96,1.02) | 1.02 (0.95,1.08) | 0.92 (0.82,1.03) | 1.00 (0.81,1.25) | 0.92 (0.86,0.98) | 0.98 (0.96,1) | 0.98 (0.97,1.00) |
| Poorly-differentiated | 1.01 (0.97,1.04) | 1.06 (0.99,1.14) | 0.94 (0.81,1.08) | 0.97 (0.75,1.26) | 0.91 (0.84,0.98) | 1.03 (1.01,1.06) | 1.04 (1.02,1.06) |
| Unknown/Missing | 1.04 (1.00,1.08) | 1.21 (1.12,1.31) | 0.82 (0.69,0.97) | 0.77 (0.55,1.06) | 0.78 (0.70,0.86) | 1.03 (1.01,1.06) | 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 | 1.05 (1.00,1.09) | 1.00 (0.92,1.08) | 1.05 (0.90,1.23) | 0.95 (0.71,1.27) | 1.04 (0.95,1.13) | 1.05 (1.02,1.08) | 1.05 (1.02,1.07) |
| Unknown | 1.11 (1.08,1.15) | 1.40 (1.32,1.49) | 0.91 (0.80,1.05) | 0.84 (0.64,1.10) | 0.74 (0.68,0.81) | 1.09 (1.07,1.11) | 1.09 (1.07,1.11) |
| Chemotherapy | |||||||
| No | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
| Yes | 0.83 (0.80,0.86) | 0.89 (0.83,0.96) | 0.71 (0.61,0.83) | 0.93 (0.72,1.20) | 1.03 (0.95,1.11) | 0.92 (0.90,0.94) | 0.92 (0.90,0.94) |
| Radiotherapy | |||||||
| 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) | 0.80 (0.77,0.84) | 0.82 (0.74,0.9) | 0.92 (0.77,1.09) | 1.03 (0.98,1.09) | 0.81 (0.79,0.82) | 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 | 1.05 (1.01,1.08) | 0.93 (0.87,1.00) | 1.09 (0.97,1.24) | 1.15 (0.92,1.44) | 1.33 (1.25,1.43) | 1.20 (1.18,1.23) | 1.20 (1.18,1.22) |
| ≥2 | 1.16 (1.09,1.24) | 1.21 (1.05,1.40) | 1.24 (0.96,1.61) | 1.51 (0.94,2.41) | 1.34 (1.16,1.54) | 1.48 (1.42,1.53) | 1.47 (1.42,1.53) |
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.