Observational studyJournal of Alzheimer's disease : JAD2022
Sex and Gender Differences in Environmental Influences on Dementia Incidence in Germany, 2014-2019: An Observational Cohort Study Based on Health Claims Data.
Observational study in Journal of Alzheimer's disease : JAD, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
7 citing papers in PubMed, 11 citations in OpenAlex.
- Modification of Hospitalization Risk by Gender and Dementia Status Between the Ages of 85 and 95 in a German Cohort Based on Health Claims Data.BMC health services research · 2026Article
- Gender differences in the influence of environmental hazards on dementia in older adults.The Gerontologist · 2026Article
- Anti-Inflammatory and Neuroprotective Polyphenols Derived from the European Olive Tree,International journal of molecular sciences · 2024Review
- Dementia in Germany: epidemiology, trends and challenges.Journal of health monitoring · 2023Article
- Spatial disparity and factors associated with dementia mortality: A cross-sectional study in Zhejiang Province, China.Frontiers in public health · 2023Article
- The role of geographic information system and global positioning system in dementia care and research: a scoping review.International journal of health geographics · 2022Article
- Article
Corrections and comments
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere is an ongoing debate about whether environmental characteristics influence dementia risk like individual traits do, and whether these differ by sex and gender.
objectiveThis study examines the influence of regional characteristics on the incidence of dementia and explores sex and gender differences using individual-level health information and regional characteristics.
methodsUsing a random sample of 250,000 people aged 70 + insured through Germany's largest German public health agency, we analyzed quarterly data about diagnoses and place of residence from 2014 to 2019. Using five-digit postal codes, we added data on various dimensions of regional characteristics offered by the INKAR database and the 2011 Census database. We used multilevel survival regressions to tease out regional incidence differences while accounting for spatial clustering.
resultsAfter adjusting for multi-morbidity and relocation-related selection bias, we saw that people living in regions with the highest tertile of income (HR = 0.87, p < 0.001), and who had the highest tertile of remaining life expectancy at age 60 (HR = 0.93, p = 0.012) had lower dementia risks. There was no gender difference in the regional income effect, but the effect of education (HR = 0.91, p = 0.015) was significant only for men and remaining life-expectancy was significant only for women (HR = 0.93, p = 0.026).
conclusionEnvironmental characteristics related to wealth and health resources of a region influence the risk of dementia among the elderly in Germany. This effect is independent of the health profiles of the individuals and differs between the two genders. Health policies need to acknowledge these modifiable risk factors and consider how they affect men and women differently.
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Registered trials
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