Hyemi Park1, Dong-Hyuk Yim2,3, Bolormaa Ochirpurev3, Sang-Yong Eom3, In Ah Choi4,5, Gawon Ju1, Ji Hyoun Kim4. 1. Department of Psychiatry, Chungbuk National University Hospital, Cheongju, Korea. 2. Center for Environmental Medicine, Chungbuk National University, Cheongju, Korea. 3. Department of Preventive Medicine, College of Medicine, Chungbuk National University, Cheongju, Korea. 4. Division of Rheumatology, Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Korea. 5. Division of Rheumatology, Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea.
Abstract
OBJECTIVES: Systemic rheumatic disease is characterized by autoimmunity and systemic inflammation and affects multiple organs. Few studies have investigated whether autoimmune diseases increase the risk of dementia. Herein, we evaluate the relationship between systemic rheumatic disease and dementia through a population-based study using the Korean National Health Insurance Service (NHIS) claims database. METHODS: We conducted a nationwide population-based study using the Korean NHIS database, consisting of individuals who submitted medical claims from 2002-2013. Dementia was defined as having an acetylcholinesterase inhibitors (AChEIs) prescription along with symptoms satisfying the Alzhemier's disease (AD) International Classification of Diseases (ICD)-10 codes (F00 or G30), or vascular dementia (VaD; ICD-10 or F01) criteria. Control subjects were matched to the dementia patients by age and sex. The study group was limited to those diagnosed with rheumatic disease at least 6 months prior to diagnosis of dementia. Rheumatic disease was defined by the following ICD-10 codes: Rheumatoid arthritis (RA: M05), Sjögren's syndrome (SS: M35), systemic lupus erythematosus (SLE: M32), and Behcet's disease (BD: M35.2). RESULTS: Of the 6,028 dementia patients, 261 (4.3%) had RA, 108 (1.6%) had SS, 12 (0.2%) had SLE, and 6 (0.1%) had BD. SLE history was significantly higher in dementia patients (0.2%) than in controls (0.1%) and was associated with dementia (odds ratio [OR], 2.48; 95% confidence interval [CI], 1.19-5.15). In subgroup analysis, SLE significantly increased dementia risk, regardless of dementia type (AD: OR, 2.29; 95% CI, 1.06-4.91; VaD: OR, 4.54; 95% CI, 1.36-15.14). However, these associations were not sustained in the mild CCI or elderly group. CONCLUSION: SLE was independently associated with a higher risk of dementia, including AD and VaD when compared to the control group, even after adjustment. SLE patients (<65 years old) are a high-risk group for early vascular dementia and require screening for early detection and active prevention.
OBJECTIVES:Systemic rheumatic disease is characterized by autoimmunity and systemic inflammation and affects multiple organs. Few studies have investigated whether autoimmune diseases increase the risk of dementia. Herein, we evaluate the relationship between systemic rheumatic disease and dementia through a population-based study using the Korean National Health Insurance Service (NHIS) claims database. METHODS: We conducted a nationwide population-based study using the Korean NHIS database, consisting of individuals who submitted medical claims from 2002-2013. Dementia was defined as having an acetylcholinesterase inhibitors (AChEIs) prescription along with symptoms satisfying the Alzhemier's disease (AD) International Classification of Diseases (ICD)-10 codes (F00 or G30), or vascular dementia (VaD; ICD-10 or F01) criteria. Control subjects were matched to the dementiapatients by age and sex. The study group was limited to those diagnosed with rheumatic disease at least 6 months prior to diagnosis of dementia. Rheumatic disease was defined by the following ICD-10 codes: Rheumatoid arthritis (RA: M05), Sjögren's syndrome (SS: M35), systemic lupus erythematosus (SLE: M32), and Behcet's disease (BD: M35.2). RESULTS: Of the 6,028 dementiapatients, 261 (4.3%) had RA, 108 (1.6%) had SS, 12 (0.2%) had SLE, and 6 (0.1%) had BD. SLE history was significantly higher in dementiapatients (0.2%) than in controls (0.1%) and was associated with dementia (odds ratio [OR], 2.48; 95% confidence interval [CI], 1.19-5.15). In subgroup analysis, SLE significantly increased dementia risk, regardless of dementia type (AD: OR, 2.29; 95% CI, 1.06-4.91; VaD: OR, 4.54; 95% CI, 1.36-15.14). However, these associations were not sustained in the mild CCI or elderly group. CONCLUSION:SLE was independently associated with a higher risk of dementia, including AD and VaD when compared to the control group, even after adjustment. SLEpatients (<65 years old) are a high-risk group for early vascular dementia and require screening for early detection and active prevention.
Authors: Daniel Coluccia; Oliver T Wolf; Spyros Kollias; Benno Roozendaal; Adrian Forster; Dominique J-F de Quervain Journal: J Neurosci Date: 2008-03-26 Impact factor: 6.167
Authors: Rashid Deane; Shi Du Yan; Ram Kumar Submamaryan; Barbara LaRue; Suzana Jovanovic; Elizabeth Hogg; Deborah Welch; Lawrence Manness; Chang Lin; Jin Yu; Hong Zhu; Jorge Ghiso; Blas Frangione; Alan Stern; Ann Marie Schmidt; Don L Armstrong; Bernd Arnold; Birgit Liliensiek; Peter Nawroth; Florence Hofman; Mark Kindy; David Stern; Berislav Zlokovic Journal: Nat Med Date: 2003-07 Impact factor: 53.440