Stress Disorders and Dementia in the Danish Population

• Published in: American journal of epidemiology 2019-03, Vol.188 (3), p.493-499
• Main Authors: Gradus, Jaimie L, Horváth-Puhó, Erzsébet, Lash, Timothy L, Ehrenstein, Vera, Tamang, Suzanne, Adler, Nancy E, Milstein, Arnold, Glymour, M Maria, Henderson, Victor W, Sørensen, Henrik T
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Bodily injury; Cohort analysis; Cohort Studies; Dementia; Dementia - epidemiology; Dementia - psychology; Dementia disorders; Denmark - epidemiology; Diagnosis; Disorders; Female; Gender aspects; Humans; Industrial safety; Male; Men; Middle Aged; Original Contributions; Population studies; Post traumatic stress disorder; Proportional Hazards Models; Registries; Risk Factors; Sex; Sex differences; Sex Factors; Stress; Stress Disorders, Traumatic - epidemiology; Stress Disorders, Traumatic - psychology; Stress, Psychological - epidemiology; Stress, Psychological - psychology
• ISSN: 0002-9262; 1476-6256
• DOI: 10.1093/aje/kwy269

Abstract There is an association between stress and dementia. However, less is known about dementia among persons with varied stress responses and sex differences in these associations. We used this population-based cohort study to examine dementia among persons with a range of clinician-diagnosed stress disorders, as well as the interaction between stress disorders and sex in predicting dementia, in Denmark from 1995 to 2011. This study included Danes aged 40 years or older with a stress disorder diagnosis (n = 47,047) and a matched comparison cohort (n = 232,141) without a stress disorder diagnosis with data from 1995 through 2011. Diagnoses were culled from national registries. We used Cox proportional hazards regression to estimate associations between stress disorders and dementia. Risk of dementia was higher for persons with stress disorders than for persons without such diagnosis; adjusted hazard ratios ranged from 1.6 to 2.8. There was evidence of an interaction between sex and stress disorders in predicting dementia, with a higher rate of dementia among men with stress disorders except posttraumatic stress disorder, for which women had a higher rate. Results support existing evidence of an association between stress and dementia. This study contributes novel information regarding dementia risk across a range of stress responses, and interactions between stress disorders and sex.