Evaluation of Selective Survival and Sex/Gender Differences in Dementia Incidence Using a Simulation Model

Key Points Question Can selective survival plausibly explain reported sex/gender differences in dementia incidence? Findings In this decision analytical model of 100 000 simulated adults aged 50 years and without dementia at baseline, sex/gender differences in dementia incidence consistent with literature (ie, 15%-20% elevated risk for women aged ≥85 years) were only observed in the presence of moderate to strong effects of selective survival characteristics that differed by sex/gender. Meaning These findings suggest that selective survival may contribute to sex/gender differences in dementia incidence but do not preclude the potential for additional contributions from biological mechanisms.