School of Traditional Chinese Medicine, Chang Gung University, Taoyuan, Taiwan; Research Center for Chinese Herbal Medicine and Research Center for Food and Cosmetic Safety, College of Human Ecology, Chang Gung University of Science and Technology, Taoyuan, Taiwan; Liver Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Ann Allergy Asthma Immunol. 2021 Aug;127(2):200-205. doi: 10.1016/j.anai.2021.03.001. Epub 2021 Mar 11.
Retrospective studies have suggested that patients with dementia have higher prevalence of atopic dermatitis (AD) than those without dementia. However, the temporal association of AD with subsequent dementia remains unknown.
To assess the temporal association of AD with subsequent dementia.
We included data of patients with AD aged 45 years and older (n = 1059) and 1:10 age, sex, residence, income, and dementia-related comorbidity-matched controls (n = 10,590) from the Taiwan National Health Insurance Research Database and reviewed their subsequent dementia development from the enrollment date to the end of 2013.
After adjustments for dementia-related comorbidities, patients with AD were found to be more likely to develop any dementia (hazard ratio [HR], 2.02; 95% confidence interval [CI], 1.24-3.29), particularly Alzheimer's disease (HR, 3.74; 95% CI, 1.17-11.97), during the follow-up period than those in the control group. Moderate-to-severe AD was associated with a high subsequent dementia risk (HR, 4.64; 95% CI, 2.58-8.33). Sensitivity analyses with the exclusion of the first 3 (HR, 2.20; 95% CI, 1.28-3.80) or 5 (HR, 2.05; 95% CI, 1.08-3.89) years of observation revealed consistent findings.
AD may be an independent risk factor for new-onset dementia. Clinicians may monitor the trajectory of neurocognitive function among elderly patients with AD. Additional studies elucidating the pathomechanisms between AD and subsequent dementia are warranted.
回顾性研究表明，痴呆患者的特应性皮炎（AD）患病率高于无痴呆患者。然而，AD 与随后发生的痴呆之间的时间关联尚不清楚。
评估 AD 与随后发生的痴呆之间的时间关联。
我们纳入了年龄在 45 岁及以上的 AD 患者（n=1059）和年龄、性别、居住地、收入相匹配的 1:10 例 AD 患者对照（n=10590）的数据，这些数据均来自台湾全民健康保险研究数据库，并从入组日期到 2013 年底，对他们随后发生痴呆的情况进行了随访。
在调整了与痴呆相关的合并症后，与对照组相比，AD 患者在随访期间发生任何痴呆（风险比[HR]，2.02；95%置信区间[CI]，1.24-3.29），尤其是阿尔茨海默病（HR，3.74；95% CI，1.17-11.97）的风险更高。中重度 AD 与较高的后续痴呆风险相关（HR，4.64；95% CI，2.58-8.33）。排除前 3 年（HR，2.20；95% CI，1.28-3.80）或前 5 年（HR，2.05；95% CI，1.08-3.89）观察的敏感性分析结果也一致。
AD 可能是新发痴呆的独立危险因素。临床医生可能需要监测老年 AD 患者的神经认知功能变化轨迹。需要进一步的研究阐明 AD 与随后发生的痴呆之间的病理机制。
