Oncotarget

Research Papers:

Septicemia is associated with increased risk for dementia: a population-based longitudinal study

Chung-Hsing Chou, Jiunn-Tay Lee _, Chun-Chieh Lin, Yueh-Feng Sung, Che-Chen Lin, Chih-Hsin Muo, Fu-Chi Yang, Chi-Pang Wen, I-Kuan Wang, Chia-Hung Kao, Chung Y. Hsu and Chun-Hung Tseng

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Oncotarget. 2017; 8:84300-84308. https://doi.org/10.18632/oncotarget.20899

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Abstract

Chung-Hsing Chou1,2, Jiunn-Tay Lee1,2, Chun-Chieh Lin1, Yueh-Feng Sung1, Che-Chen Lin3, Chih-Hsin Muo3, Fu-Chi Yang1, Chi-Pang Wen4, I-Kuan Wang5,6,7, Chia-Hung Kao5,8, Chung Y. Hsu5 and Chun-Hung Tseng9

1Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China

2Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, Republic of China

3Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan, Republic of China

4Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan, Republic of China

5Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan, Republic of China

6Department of Internal Medicine, College of Medicine, China Medical University, Taichung, Taiwan, Republic of China

7Division of Kidney Disease, China Medical University Hospital, Taichung, Taiwan, Republic of China

8Department of Nuclear Medicine, PET Center, China Medical University Hospital, Taichung, Taiwan, Republic of China

9Department of Neurology, China Medical University Hospital, Taichung, Taiwan, Republic of China

Correspondence to:

Jiunn-Tay Lee, email: [email protected]

Keywords: septicemia, infection, dementia, Alzheimer’s disease, non-Alzheimer dementias

Received: May 17, 2017    Accepted: August 04, 2017    Published: September 15, 2017

ABSTRACT

Background: Systemic infection has been linked to cognitive impairment. We hypothesized that patients with septicemia are predisposed to increased risks for developing dementia in a long-term setting.

Methods: This observational, retrospective, longitudinal, nation-wide population-based study was conducted using the data deduced from Longitudinal Health Insurance Database (LHID) in Taiwan. All patients with septicemia hospitalized for the first time from 2001 to 2011 without prior dementia were included. The development of Alzheimer’s disease (AD) or non-Alzheimer dementias (NAD) in relation to the development of septicemia for each patient was recorded. An age- and sex-matched cohort without septicemia and without prior dementia served as the control. Septicemia, dementia, and other confounding factors were defined according to International Classification of Diseases Clinical Modification Codes. Cox proportional-hazards regressions were utilized to analyze adjusted hazard ratios.

Results: Patients with septicemia had a higher risk for developing dementia based on hazard ratios (HRs) (p<0.001). Patients with septicemia in the younger age groups had a greater dementia risk (p<0.01). Septicemia was associated with subsequent NAD (p<0.001), whereas the increased risk of AD was statistically insignificant (p>0.05). Furthermore, higher severity of septicemia was associated with increased risk of developing dementia.

Conclusions: Our findings suggest that septicemia is associated with an increased risk in developing NAD but not AD. A likely causal role of septicemia in increasing the risk of NAD is suggested, according to the findings that patients with higher severity of septicemia carried greater risk of sustaining dementia.


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