The Lancet Infectious Diseases, Journal Year: 2021, Volume and Issue: 21(11), P. 1557 - 1567

Published: June 21, 2021

BackgroundInfections have been hypothesised to increase the risk of dementia. Existing studies included a narrow range infectious diseases, relied on short follow-up periods, and provided little evidence for whether increased is limited specific dementia subtypes or attributable microbes rather than infection burden. We aimed compare Alzheimer's disease other dementias across wide hospital-treated bacterial viral infections in two large cohorts with long periods.MethodsIn this large, multicohort, observational study, analysis was based primary cohort consisting pooled individual-level data from three prospective Finland (the Finnish Public Sector Health Social Support Still Working study) an independent replication UK Biobank. Community-dwelling adults (≥18 years) no at study entry were included. Follow-up until Dec 31, 2012, 2016, public sector Feb 7, 2018, cohort. Through record linkage national hospital inpatient registers, we ascertained exposure 925 diseases (using International Classification Diseases 10th Revision codes) before onset, identified incident records, medication reimbursement entitlements, death certificates. Hazard ratios (HRs) associations each group (index infection) assessed by use Cox proportional hazards models. then repeated after excluding cases that occurred during first 10 years initial hospitalisation due index infection.FindingsFrom March 1, 1986, Jan 2005, 260 490 people cohort, 19, 2006, Oct 2010, 485 708 In 3 947 046 person-years (median 15·4 [IQR 9·8–21·0]), 77 108 participants had least one onset 2768 developed Hospitalisation any associated (adjusted HR [aHR] 1·48 [95% CI 1·37–1·60]) (2·60 [2·38-2·83]). The association remained when analyses restricted new more (aHR 1·22 1·09–1·36] insufficient analysis), comorbidities factors considered. There dose-response between number episodes both (ptrend=0·0007). Although greatest seen central nervous system (CNS) versus 3·01 2·07–4·37]), excess also evident extra-CNS (1·47 [1·36–1·59]). found difference infection-dementia type infection, stronger vascular 2·09 1·59–2·75] aHR 1·20 [1·08–1·33] 3·28 [2·65–4·04] 1·80 [1·53–2·13] cohort).InterpretationSevere requiring treatment are long-term dementia, including disease. This not CNS infections, suggesting systemic effects sufficient affect brain. absence specificity combined relationships burden support hypothesis driven general inflammation microbes.FundingUK Medical Research Council, US National Institute Aging, Wellcome Trust, NordForsk, Academy Finland, Helsinki Life Science.

Language: Английский