Autoimmune rheumatic diseases increase dementia risk in middle-aged patients: A nationwide cohort study.
Autoimmune rheumatic diseases increase dementia risk in middle-aged patients: A nationwide cohort study.
复制标题
DOI：
10.1371/journal.pone.0186475
复制
发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Chang CC
中科院分区：
文献类型：
--
作者：
Lin TM;Chen WS;Sheu JJ;Chen YH;Chen JH;Chang CC
痴呆症是一种常见的神经系统疾病，严重影响公众健康。先前的一项研究表明，当身体的免疫系统攻击大脑细胞时，痴呆症就会发生，这表明痴呆症可能类似于自身免疫性风湿性疾病（ARDs）。在目前的回顾性队列研究中，我们主要关注中年ARD患者（45岁或以上），通过使用台湾全国范围内基于人群的数据库来调查中年人中的ARD与痴呆之间的关联。我们的研究分析了2001年至2012年台湾人口的医疗数据，随访期延长至2011年底。我们使用台湾全民健康保险研究数据库来确定中年ARDs患者。我们从一般人群中选择了一个对照队列，按年龄（以5岁为增量）、性别和指数年随机频率匹配，并使用考虑性别、年龄和合并症的考克斯回归模型进一步分析痴呆风险。该研究招募了34，660名中年ARD患者（77%为女性，平均年龄= 59.8岁）和138，640名对照。在校正年龄、性别和合并症后，中年ARDs患者发生痴呆的风险是非ARDs患者的1.18倍。在ARDs患者中，类风湿性关节炎、系统性红斑狼疮和干燥综合征（SS）亚组与痴呆风险显著升高相关（校正的风险比[HR] 1.14，95%置信指数[CI] 1.06-1.32;校正的HR 1.07，95% CI 0.86-1.34;校正的HR 1.46，95% CI 1.32-1.63）。此外，在所有ADR亚组中，原发性SS和继发性SS患者发生痴呆的风险最高（校正HR 1.35，95% CI 1.18-1.54;校正HR 1.67，95% CI 1.43-1.95）。这项全国性的回顾性队列研究表明，与普通人群相比，中年ARDs患者的痴呆风险显著较高。
Dementia is a common neurological disease that substantially affects public health. A previous study revealed that dementia occurs when the body’s immune system attacks the cells of the brain, indicating that dementia may be similar to autoimmune rheumatic diseases (ARDs). In the current retrospective cohort study, we focused on middle-aged ARD patients (45 years or older) to investigate the association between ARDs in middle-aged people and dementia by using a nationwide population-based database in Taiwan. Our study analyzed the medical data of the Taiwanese population from 2001 to 2012, with a follow-up period extending until the end of 2011. We identified middle-aged patients with ARDs by using the Taiwan National Health Insurance Research Database. We selected a comparison cohort from the general population that was randomly frequency-matched by age (in 5-year increments), sex, and index year and further analyzed the dementia risk by using a Cox regression model that considers sex, age, and comorbidities. The study enrolled 34,660 middle-aged ARD patients (77% female, mean age = 59.8 years) and 138,640 controls. The risk of developing dementia was 1.18 times higher for middle-aged patients with ARDs compared with patients without ARDs after adjustment for age, sex, and comorbidities. Among the patients with ARDs, the subgroups with rheumatoid arthritis, systemic lupus erythematosus, and Sjögren syndrome (SS) were associated with a significantly higher dementia risk (adjusted hazard ratio [HR] 1.14, 95% confidence index [CI] 1.06–1.32; adjusted HR 1.07, 95% CI 0.86–1.34; adjusted HR 1.46, 95% CI 1.32–1.63, respectively). Furthermore, primary SS and secondary SS patients had the highest risks of dementia among all the ADR subgroups (adjusted HR 1.35, 95% CI 1.18–1.54; adjusted HR 1.67, 95% CI 1.43–1.95 respectively). This nationwide retrospective cohort study demonstrated that dementia risk is significantly higher in middle-aged patients with ARDs compared with the general population.
登录
查看更多内容
影响因子：
5.3
作者：
Jimenez, Sebastian;Baglietto-Vargas, David;Vitorica, Javier
通讯作者：
Vitorica, Javier
影响因子：
--
作者：
Enciu AM;Popescu BO
通讯作者：
Popescu BO
影响因子：
6.2
作者：
Bsibsi, M;Persoon-Deen, C;Van Noort, JM
通讯作者：
Van Noort, JM
影响因子：
4.1
作者：
Iannaccone, S.;Cerami, C.;Perani, D.
通讯作者：
Perani, D.
影响因子：
6.2
作者：
Cunningham, Colm
通讯作者：
Cunningham, Colm