192. Preeclampsia and risk of dementia later in life

Introduction Preeclampsia has been linked with later cognitive impairment and brain atrophy, but epidemiologic studies have not confirmed a link with dementia later in life. Objective To explore associations between preeclampsia and later dementia, by dementia subtype and timing of onset. Methods Our study cohort included all women in Denmark with ⩾1 live birth or stillbirth between 1978 and 2015. Using Danish national registers, we identified women who subsequently developed dementia. We used Cox regression to estimate hazard ratios comparing dementia risk among women with and without a history of preeclampsia. Results Our cohort consisted of 1,178,005 women with 20,352,695 person-years of follow-up. Women with a history of preeclampsia had a 53% increase in risk of dementia overall (hazard ratio [HR], 1.53; 95% confidence interval [CI], 1.26–1.85) and more than three times the risk of vascular dementia (HR, 3.46; 95% CI, 1.97–6.10) later in life, compared with women with no history of preeclampsia. In contrast, only modest associations were observed for both Alzheimer’s disease (HR 1.45; 95% CI 1.05–1.99) and unspecified dementia (HR, 1.40; 95% CI 1.08–1.83). The association with vascular dementia appeared to be stronger for late-onset disease (age ⩾65 years, HR, 6.53; 95% CI, 2.82–15.1) than for early-onset disease (age Discussion Preeclampsia was associated with an increased risk of dementia, vascular dementia in particular. Cardiovascular disease, hypertension, and diabetes were unlikely to mediate the associations substantially, suggesting that preeclampsia and vascular dementia may share underlying mechanisms or susceptibility pathways.