Epidemiology, IQVIA, Frankfurt, Germany.
Institute for Social Medicine, Occupational Medicine, and Public Health (ISAP) of the Medical Faculty at the University of Leipzig, Leipzig, Germany.
J Alzheimers Dis. 2021;80(4):1471-1478. doi: 10.3233/JAD-210103.
The critical role of inflammatory processes in the pathogenesis of dementia has recently been established.
The aim of this study was to investigate the association between inflammatory bowel disease (IBD) and dementia risk in patients followed in general practices in Germany.
This study included patients aged over 60 with an initial diagnosis of IBD (Crohn's Disease (CD), ulcerative colitis (UC)) who were followed in 1,159 German general practices between January 1995 and December 2014. IBD patients were matched to healthy patients using propensity scores based on age, gender, index year, insurance type and comorbidities. Kaplan-Meier curves were used to study the development of dementia in patients with or without IBD within up to 15 years of the index date. Cox proportional hazard regression models were used to estimate the relationship between IBD and dementia.
The study included 3,850 patients with and 3,850 patients without IBD and revealed a higher cumulative incidence of dementia in IBD patients than in non-IBD patients after the follow-up period. The cumulative incidence of dementia differed within IBD subtypes; it was significantly higher in UC patients than in CD patients. Cox proportional hazard models showed that IBD is associated with a 1.22-fold increase in the risk (95% CI: 1,07-1,39) of developing dementia. UC patients had a 1.25-fold higher risk of developing dementia (95% CI: 1.07-1.46). CD is not significantly associated with an increased risk of dementia (HR: 1.17, 95% CI: 0.93-1.47).
A positive association between IBD and dementia was found in patients followed in general practices in Germany.
炎症过程在痴呆症发病机制中的关键作用最近已得到证实。
本研究旨在调查德国普通诊所中随访的炎症性肠病（IBD）患者与痴呆风险之间的关系。
本研究纳入了年龄在 60 岁以上、有初始 IBD（克罗恩病（CD）、溃疡性结肠炎（UC））诊断且于 1995 年 1 月至 2014 年 12 月在 1159 家德国普通诊所中随访的患者。IBD 患者与健康患者基于年龄、性别、索引年、保险类型和合并症进行倾向评分匹配。使用 Kaplan-Meier 曲线研究索引日期后长达 15 年内有无 IBD 的患者痴呆的发展情况。使用 Cox 比例风险回归模型估计 IBD 与痴呆之间的关系。
该研究纳入了 3850 例有 IBD 和 3850 例无 IBD 的患者，在随访期间，IBD 患者的痴呆累积发生率高于非 IBD 患者。IBD 亚型的累积发病率不同；UC 患者明显高于 CD 患者。Cox 比例风险模型表明，IBD 与痴呆风险增加 1.22 倍相关（95%CI：1.07-1.39）。UC 患者发生痴呆的风险增加 1.25 倍（95%CI：1.07-1.46）。CD 与痴呆风险增加无关（HR：1.17，95%CI：0.93-1.47）。
在德国普通诊所中随访的 IBD 患者与痴呆之间存在正相关关系。
