Evidence map›Paper›PMID 41536502›Full record

ArticleLancet regional health. Americas2026

Sex differences in the association of vascular risk and APOE Genotype with cognitive decline and dementia: evidence from a U.S. longitudinal study.

Longjian Liu, Jintong Hou, Saishi Cui, Xiaopeng Zhao, Zuolu Liu, J Craig Longenecker, Nathalie S May, Jin Jun Luo, Rose Ann DiMaria-Ghalili, Howard J Eisen

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Lancet regional health. Americas, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Longjian LiuDepartment of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA.
Jintong HouDepartment of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA.
Saishi CuiDepartment of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA.
Xiaopeng ZhaoDepartment of Mechanical, Aerospace, and Biomedical Engineering, University of Tennessee Knoxville TN, 37996, USA.
Zuolu LiuNeurology, California Pacific Medical Center, Sutter Health, San Francisco, CA, 94109, USA.
J Craig LongeneckerDepartment of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA.
Nathalie S MayDepartment of Medicine, College of Medicine, Drexel University, Philadelphia, PA, 19104, USA.
Jin Jun LuoDepartment of Neurology, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, 19140, USA.
Rose Ann DiMaria-GhaliliDoctoral Nursing Department, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, 19104, USA.
Howard J EisenClinical Research for the Advanced Cardiac and Pulmonary Vascular Disease Program, Thomas Jefferson University Hospital, Philadelphia, PA, 19107, USA.

Funding

The predicative values of vascular and metabolic disorders for risk of incident mild cognitive impairment and dementiaR21AG082210 · NIA · DREXEL UNIVERSITY · PI LIU, LONGJIAN · 2023 to 2024
$403k
NIA NIH HHS R21 AG082210
6 · The paper itself

Abstract

Background: Sex differences in the association between vascular factors and cognitive outcomes remain unclear. We aimed to investigate the associations of blood pressure metrics (hypertension, systolic blood pressure [SBP), pulse pressure, ankle and brachial pressures, and ankle to brachial pressure index [ABI]) with the risk of cognitive decline and dementia. Methods: We conducted a population-based longitudinal analysis using data from the Atherosclerosis Risk in Communities (ARIC) study (begun in 1987-1989) in the United States. We analyzed a total of 12,268 participants aged 45-64 years who had validated exposure measurements, cognitive function tests (first administrated 1990-1992), and followed up for incidence of dementia through December 2019. Cognitive function was assessed using the Digit Symbol Substitution Test, the Delayed Word Recall Test, and the Word Fluency Test. Dementia cases were identified through a standardized clinical evaluation process, mostly adjudicated by expert reviewers. We performed sex-stratified analyses to examine the associations of blood pressure metrics and APOE ε4 allele with the risk of cognitive decline and dementia. Findings: Over a median follow-up of 26.4 years, 2698 participants developed dementia. Women aged 55-64 had a significantly higher incidence of dementia than men aged 55-64 (14.8 vs. 11.8 per 1000 person-years; p < Interpretation: These findings highlight notable sex differences in the association between vascular factors and cognitive decline and dementia risk. Women appear more vulnerable to both genetic and vascular risk factors, emphasizing the need for sex-specific approaches in research, prevention, and intervention strategies for cognitive impairment. Funding: NIH.

Indexed as

Cognitive declineDementiaGenetic riskLongitudinal studySex differencesVascular risk

Identifiers

PMID41536502
PMCPMC12796570

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.