Division of Neurosurgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Department of Emergency Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Int J Clin Pract. 2021 Aug;75(8):e14318. doi: 10.1111/ijcp.14318. Epub 2021 Jun 28.
To investigate the epidemiological relationship between dengue fever and the subsequent development of dementia.
Using nationwide Taiwan registries from the National Health Insurance Research (NHIRD), we identified adults aged over 40 years who received a dengue fever diagnosis from 1 January 2000 to 31 December 2012 and who did not have a history of dementia. We used a propensity score match (PSM) to balance the baseline characteristics between groups. All eligible adults were sorted into either the dengue group or non-dengue group at a ratio of 1:4, matching by age, sex, index years, income level, and relevant comorbidities. Using Cox regression with proportional hazards models, we estimated the risk of dementia. The study period started from 1 January 2000 to 31 December 2013. We conducted sensitivity analyses to cross-validate study results.
With a median of 8.01 years of follow-up, patients in the dengue group were more at risk of developing dementia than the non-dengue group. The estimated cumulative incidence of dementia was 7.21% in the dengue group and 4.03% in the non-dengue group (adjusted hazard ratio (aHR), 1.71; 95% CI, 1.03 to 2.83). Sensitivity analyses yielded consistent findings. We excluded any stroke cases before the end of the study, and subgroup analysis by follow-up time showed that the dengue group has a significantly higher risk of new-onset dementia >6 years after the index date (aHR 3.24; 95% CI, 1.42 to 7.37). The P value for interaction was significant (<.0001).
This study demonstrated a significantly higher risk of dementia in patients with dengue fever in Taiwan than in those without dengue fever.
研究登革热与随后痴呆发展之间的流行病学关系。
利用国家健康保险研究（NHIRD）的全国性台湾注册数据，我们确定了 2000 年 1 月 1 日至 2012 年 12 月 31 日期间年龄超过 40 岁的成年人，他们患有登革热且没有痴呆病史。我们使用倾向评分匹配（PSM）来平衡两组之间的基线特征。所有符合条件的成年人按照年龄、性别、指数年、收入水平和相关合并症，以 1:4 的比例分为登革热组或非登革热组。使用 Cox 比例风险模型估计痴呆的风险。研究期间从 2000 年 1 月 1 日开始至 2013 年 12 月 31 日结束。我们进行敏感性分析以交叉验证研究结果。
在中位数为 8.01 年的随访期间，登革热组患者发展为痴呆的风险高于非登革热组。登革热组的累积痴呆发生率为 7.21%，而非登革热组为 4.03%（调整后的风险比[aHR]，1.71；95%CI，1.03 至 2.83）。敏感性分析得出了一致的结果。我们排除了研究结束前的任何中风病例，并且通过随访时间进行的亚组分析表明，登革热组在指数日期后 6 年以上发生新发痴呆的风险显著更高（aHR，3.24；95%CI，1.42 至 7.37）。交互作用的 P 值显著（<0.0001）。
本研究表明，在台湾，患有登革热的患者患痴呆的风险明显高于未患登革热的患者。
