Aging
Cancer History and Risk of Alzheimer’s Disease in Women: A Nested Case–Control Study in the NYU Women’s Health Study Xiaolan Zhao* Xiaolan Zhao Zhao Zhao Zhao Zhao Zhao Zhao NYU Langone Department of Population Health
Abstract
Background: Previous observational studies have reported an inverse association between cancer and Alzheimer’s disease (AD). However, important knowledge gaps remain, including whether this inverse relationship is consistent across cancer subtypes.
Methods: The New York University Women’s Health Study (NYUWHS) enrolled 14,273 AD-free women aged 35–65 years between 1985 and 1991 and followed them for over 30 years. Incident cancer diagnoses were ascertained through self-completed mailed questionnaires verified by medical records and tumor registries. AD diagnoses were ascertained through linkage with the Centers for Medicare & Medicaid Services (CMS). We conducted a nested case-control study of 1,632 AD cases identified through Medicare claims linkage and 2,911 controls selected using risk-set sampling matching on age, race/ethnicity, and Medicare coverage. We used conditional logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between cancer and AD, adjusting for potential confounders. Inverse probability weights based on selection predictors were applied in weighted conditional logistic regression models.
Results: Overall, a history of any cancer prior to AD was associated with lower odds of subsequent AD during follow-up compared with no cancer history (OR = 0.80, 95% CI = 0.70–0.92). In IPW-weighted analyses, the 95% CI was slightly narrower (OR = 0.80, 95% CI = 0.75–0.87). When assessing associations for each specific cancer, the inverse association was more pronounced for breast cancer (OR = 0.80, 95% CI = 0.73–0.88), endometrial cancer (OR = 0.73, 95% CI = 0.55–0.95), and melanoma (OR = 0.60, 95% CI = 0.49–0.74).
Conclusions: Among women in a long-term prospective cohort, cancer history was associated with reduced odds of developing AD, particularly hormone-related cancers.
Keywords: Alzheimer’s disease, cancer, breast cancer, midlife risk factors, women’s health, prospective nested case-control study