Lars I Eriksson1, Cecilia Lundholm2, Kaavya Narasimhalu2, Rolf Sandin3, Ya-Ping Jin4, Margaret Gatz5, Nancy L Pedersen6. 1. Department of Physiology and Pharmacology, Section for Anesthesiology and Intensive Care Medicine, Karolinska Institutet, Stockholm, Sweden; Function Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden. 2. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. 3. Department of Physiology and Pharmacology, Section for Anesthesiology and Intensive Care Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Anesthesia and Intensive Care, Kalmar County Hospital, Kalmar, Sweden. 4. Department of Ophthalmology and Vision Sciences, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. 5. Department of Psychology, University of Southern California, Los Angeles, CA, USA; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. 6. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Psychology, University of Southern California, Los Angeles, CA, USA. Electronic address: nancy.pedersen@ki.se.
Abstract
INTRODUCTION: We evaluated whether hospitalization with or without surgery increases risk for dementia or Alzheimer's disease. METHODS: A clinical sample (843 clinically diagnosed dementia cases; 1686 matched nondemented individuals) was identified from Swedish Twin Registry studies. A register-based sample (4293 cases; 21,465 matched controls) was identified by linkage of Swedish Twin Registry to Swedish Patient Registry records. Apolipoprotein E (APOE) status and within-pair comparisons of dementia discordant twins indicated genetic susceptibility. RESULTS: Nonsurgical hospitalization is associated with greater dementia risk than hospitalization with surgical intervention. In the register sample, thoracic, abdominal, and major orthopedic procedures entailed dementia risk; in the clinical sample, orthopedic alone. Within-pair analyses indicate that associations in part reflect genetic susceptibility in common to hospitalization and dementia. Potential gene-environment interactions were indicated by greater risk due to hospitalization among APOE ε4 noncarriers. DISCUSSION: We confirm hospitalization as a risk factor for dementia, with repeated hospitalizations a more important risk factor than surgery.
INTRODUCTION: We evaluated whether hospitalization with or without surgery increases risk for dementia or Alzheimer's disease. METHODS: A clinical sample (843 clinically diagnosed dementia cases; 1686 matched nondemented individuals) was identified from Swedish Twin Registry studies. A register-based sample (4293 cases; 21,465 matched controls) was identified by linkage of Swedish Twin Registry to Swedish Patient Registry records. Apolipoprotein E (APOE) status and within-pair comparisons of dementia discordant twins indicated genetic susceptibility. RESULTS: Nonsurgical hospitalization is associated with greater dementia risk than hospitalization with surgical intervention. In the register sample, thoracic, abdominal, and major orthopedic procedures entailed dementia risk; in the clinical sample, orthopedic alone. Within-pair analyses indicate that associations in part reflect genetic susceptibility in common to hospitalization and dementia. Potential gene-environment interactions were indicated by greater risk due to hospitalization among APOE ε4 noncarriers. DISCUSSION: We confirm hospitalization as a risk factor for dementia, with repeated hospitalizations a more important risk factor than surgery.
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