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非囊性纤维化支气管扩张症与痴呆发病风险的关联:一项全国性队列研究。

Association between non-cystic fibrosis bronchiectasis and the risk of incident dementia: A nationwide cohort study.

机构信息

Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea.

Department of Internal Medicine, Dongguk University Gyeongju Hospital, Dongguk University College of Medicine, Gyeongju, Korea.

出版信息

Chron Respir Dis. 2023 Jan-Dec;20:14799731231222282. doi: 10.1177/14799731231222282.

Abstract

BACKGROUND

Chronic lung diseases, such as chronic obstructive pulmonary disease or asthma, are associated with an increased risk of dementia. However, few data are available regarding the risk of dementia in individuals with bronchiectasis.

OBJECTIVES

To explore the association between bronchiectasis and the risk of incident dementia using a longitudinal population-based cohort.

METHODS

A total of 4,068,560 adults older than 50 years without previous dementia were enrolled from the Korean National Health Insurance Service database in 2009. They were followed up until the date of the diagnosis of dementia or December 31, 2020. The study exposure was the diagnosis of bronchiectasis, and the primary outcome was incident dementia comprising Alzheimer's disease and vascular dementia.

RESULTS

During the median follow-up duration of 9.3 years, the incidence of all-cause dementia was 1.6-fold higher in individuals with bronchiectasis than in those without bronchiectasis (15.0 vs. 9.3/1000 person-years, < .001). In the multivariable Cox regression analysis, the risk of all dementia was significantly higher in individuals with bronchiectasis than in those without bronchiectasis (adjusted hazard ratio [aHR] 1.09, 95% confidence interval [CI] 1.04-1.14). In a subgroup analysis by dementia type, individuals with bronchiectasis had an increased risk of Alzheimer's disease compared to those without bronchiectasis (aHR 1.07, 95% CI 1.01-1.12); the risk of vascular dementia did not significantly differ between the two groups (aHR 1.05, 95% CI 0.90-1.21).

CONCLUSION

Bronchiectasis was associated with an increased risk of dementia, especially Alzheimer's disease.

摘要

背景

慢性肺部疾病,如慢性阻塞性肺疾病或哮喘,与痴呆风险增加相关。然而,关于支气管扩张症患者痴呆风险的数据很少。

目的

使用纵向人群队列研究来探讨支气管扩张症与痴呆发病风险之间的关系。

方法

本研究共纳入了 2009 年来自韩国国家健康保险服务数据库的 4068560 名年龄大于 50 岁且无既往痴呆的成年人。他们的随访时间截至痴呆诊断日期或 2020 年 12 月 31 日。研究暴露为支气管扩张症的诊断,主要结局为包括阿尔茨海默病和血管性痴呆在内的新发痴呆。

结果

在中位随访 9.3 年期间,支气管扩张症患者的全因痴呆发生率是无支气管扩张症患者的 1.6 倍(15.0/1000 人年比 9.3/1000 人年,<0.001)。在多变量 Cox 回归分析中,支气管扩张症患者发生所有痴呆的风险显著高于无支气管扩张症患者(调整后的风险比[aHR]1.09,95%置信区间[CI]1.04-1.14)。按痴呆类型进行亚组分析时,支气管扩张症患者发生阿尔茨海默病的风险高于无支气管扩张症患者(aHR 1.07,95%CI 1.01-1.12);两组发生血管性痴呆的风险无显著差异(aHR 1.05,95%CI 0.90-1.21)。

结论

支气管扩张症与痴呆风险增加相关,尤其是阿尔茨海默病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a4c0/10725102/b9e057e969f2/10.1177_14799731231222282-fig1.jpg

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