Department of Family Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Republic of Korea; Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Department of Family Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Republic of Korea.
J Infect Public Health. 2024 Feb;17(2):286-292. doi: 10.1016/j.jiph.2023.12.006. Epub 2023 Dec 12.
Concern has been growing regarding post-tuberculosis (TB) morbidities, including neurologic and vascular comorbidities. However, the association between post-TB status and the risk of dementia has been evaluated in only few studies. Therefore, in the present study, the risk of dementia was investigated in a nationwide population-based cohort.
Using the Korean National Health Insurance Service (KNHIS) database, this study included TB survivors (n = 50,182) and matched controls (n = 50,182) for age, sex, and year of index date. The risk of dementia was estimated using Cox proportional hazards regression, and stratified analyses for related factors were performed.
During a mean 3.5 years of follow-up, the incidence of dementia was 9.32 for Alzheimer disease and 1.17 for vascular dementia per 1000 person-years for TB survivors and 7.21 and 0.67, respectively, for matched controls. The overall risk of Alzheimer disease was 1.11 (95% confidence interval (CI) 1.03-1.20)-fold higher in TB survivors than in matched controls. For vascular dementia, 1.48 (95% CI 1.16-1.89)-fold higher risk was found in TB survivors than in matched controls. The strength of the association between TB and dementia was higher in CNS TB (aHR 1.76, 95% CI 1.18 -2.64) than non-CNS TB (aHR 1.11, 95% CI 1.05-1.19) compared to controls, especially for patients with vascular dementia (3.33, 95% CI 1.06-10.49).
TB survivors had a significantly higher risk of dementia than the general population.
人们对肺结核（TB）后出现的多种并发症越来越关注，包括神经系统和血管并发症。然而，仅有少数研究评估了 TB 后状态与痴呆风险之间的关系。因此，本研究在全国范围内基于人群的队列中调查了 TB 后状态与痴呆风险的关系。
本研究使用韩国国民健康保险服务（KNHIS）数据库，纳入了 TB 幸存者（n=50182）和年龄、性别及索引日期相匹配的对照组（n=50182）。使用 Cox 比例风险回归估计痴呆风险，并进行了相关因素的分层分析。
在平均 3.5 年的随访期间，TB 幸存者的阿尔茨海默病和血管性痴呆的发病率分别为每 1000 人年 9.32 和 1.17，而匹配对照组分别为 7.21 和 0.67。与匹配对照组相比，TB 幸存者的总体阿尔茨海默病风险为 1.11（95%置信区间[CI]：1.03-1.20）倍。对于血管性痴呆，TB 幸存者的风险为 1.48（95% CI：1.16-1.89）倍。与对照组相比，中枢神经系统（CNS）TB 与痴呆之间的相关性更强（调整后危险比[aHR]：1.76，95% CI：1.18-2.64），而非 CNS TB（aHR：1.11，95% CI：1.05-1.19），尤其是血管性痴呆患者（3.33，95% CI：1.06-10.49）。
与普通人群相比，TB 幸存者痴呆风险显著升高。
