Lee Yu-Hao, Huang Shih-Wei, Chen Chih-Kuang, Hong Jia-Pei, Chen Yi-Wen, Lin Hui-Wen
Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei 23561, Taiwan.
Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan.
J Clin Med. 2023 Jan 26;12(3):950. doi: 10.3390/jcm12030950.
Axial spondyloarthritis (axSpA) is a chronic inflammatory rheumatic disease that mainly affects the axial bones, and dementia is characterized by a decline in cognitive function, leading to dependence in everyday activity. Although the association between dementia and ankylosing spondylitis has been investigated, the influence of axSpA medication on dementia risk is unclear. The aim of this study was to investigate the risk of dementia among axSpA patients and if the conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) can reduce the risk of dementia. Patients with axSpA whose data were recorded during 2004-2008 and who were followed up until the end of 2010 were recruited. A control cohort was matched by age and sex. A Cox multivariate proportional hazards model was applied to analyze the risk factors for dementia. The hazard ratio (HR) and adjusted HR (aHR) were estimated between the study and control cohorts. The effects of csDMARDs and steroid use on the risk of different types of dementia were also analyzed. In total, 2341 and 11,705 patients constituted the axSpA and control cohort, respectively. The axSpA cohort had a greater risk of vascular dementia (aHR = 2.09 (1.36-3.20). The risk of dementia (aHR = 1.01 (0.55-1.85) did not significantly differ between patients with axSpA who received csDMARDs. In conclusion, patients with axSpA are at a risk of vascular dementia, which could be reduced by csDMARDs.
中轴型脊柱关节炎（axSpA）是一种主要影响中轴骨的慢性炎症性风湿性疾病，而痴呆症的特征是认知功能下降，导致日常生活活动需要依赖他人。尽管已经对痴呆症与强直性脊柱炎之间的关联进行了研究，但axSpA药物治疗对痴呆症风险的影响尚不清楚。本研究的目的是调查axSpA患者患痴呆症的风险，以及传统合成改善病情抗风湿药物（csDMARDs）是否能降低痴呆症风险。招募了在2004年至2008年期间记录数据且随访至2010年底的axSpA患者。通过年龄和性别匹配了一个对照队列。应用Cox多变量比例风险模型分析痴呆症的风险因素。估计了研究队列和对照队列之间的风险比（HR）和调整后风险比（aHR）。还分析了csDMARDs和使用类固醇对不同类型痴呆症风险的影响。总共2341名和11705名患者分别构成了axSpA队列和对照队列。axSpA队列患血管性痴呆的风险更高（aHR = 2.09（1.36 - 3.20））。接受csDMARDs的axSpA患者患痴呆症的风险（aHR = 1.01（0.55 - 1.85））没有显著差异。总之，axSpA患者有患血管性痴呆的风险，csDMARDs可能会降低这种风险。
