Gau Shuo-Yan, Lai Jung-Nien, Yip Hei-Tung, Wu Meng-Che, Wei James Cheng-Chung
School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan.
Front Aging Neurosci. 2022 Apr 4;14:830729. doi: 10.3389/fnagi.2022.830729. eCollection 2022.
Whether or not patients with gastroesophageal reflux disease (GERD) have a higher risk of developing subsequent dementia remains unknown, and no observational evidence from population-based data is available. This study was to determine whether patients with GERD have a higher future risk of developing dementia.
For the period 2000-2012, datasets from the Longitudinal Health Insurance Database (LHID, subset of National Health Insurance Research Database in Taiwan) were analyzed. Definition of GERD was based on ICD-9-CM codes 530.11 and 530.81 and prescriptions for PPIs. After matching gender, age, index year, and comorbidities, each GERD patient was matched with four control patients without GERD. Future risk of dementia was evaluated, and sensitivity analysis of subgroups was conducted to clarify the potential association.
In the present study, 13,570 patients were included in the GERD cohort and 54,280 patients were included in the control cohort. Patients with GERD showed higher risk developing dementia than control group, with an aHR of 1.34 (95% C.I., 1.07, 1.67). In GERD patients between above 70 years old, the risk of developing dementia was higher than that of the control groups (aHR = 1.34; 95% C.I., 1.01, 1.77).
Patients with GERD showed higher incidence of dementia, and elder patients had the highest risk of developing dementia. Clinicians should be concern of the association between GERD and dementia and should develop strategies to prevent dementia while managing patients with GERD.
胃食管反流病(GERD)患者是否有更高的后续患痴呆症风险尚不清楚,且缺乏基于人群数据的观察性证据。本研究旨在确定GERD患者未来患痴呆症的风险是否更高。
分析2000 - 2012年期间纵向健康保险数据库(LHID,台湾国民健康保险研究数据库的子集)的数据。GERD的定义基于ICD - 9 - CM编码530.11和530.81以及质子泵抑制剂的处方。在匹配性别、年龄、索引年份和合并症后,将每位GERD患者与四名无GERD的对照患者进行匹配。评估痴呆症的未来风险,并进行亚组敏感性分析以阐明潜在关联。
在本研究中,GERD队列纳入了13570名患者,对照队列纳入了54280名患者。GERD患者患痴呆症的风险高于对照组,调整后风险比(aHR)为1.34(95%置信区间,1.07,1.67)。在70岁以上的GERD患者中,患痴呆症的风险高于对照组(aHR = 1.34;95%置信区间,1.01,1.77)。
GERD患者痴呆症发病率较高,老年患者患痴呆症的风险最高。临床医生应关注GERD与痴呆症之间的关联,并在管理GERD患者时制定预防痴呆症的策略。