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Chen F, Wang J, Cheng Y, Li R, Wang Y, Chen Y, Scott T, Tucker KL. Magnesium and Cognitive Health in Adults: A Systematic Review and Meta-Analysis. Adv Nutr 2024; 15:100272. [PMID: 39009081 DOI: 10.1016/j.advnut.2024.100272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 05/31/2024] [Accepted: 07/10/2024] [Indexed: 07/17/2024] Open
Abstract
Magnesium (Mg) plays a key role in neurological functioning and manifestations. However, the evidence from randomized controlled trials (RCTs) and cohorts on Mg and cognitive health among adults has not been systematically reviewed. We aimed to examine the associations of various Mg forms (supplements, dietary intake, and biomarkers) with cognitive outcomes by summarizing evidence from RCTs and cohorts. PubMed, Embase, PsycINFO, and the Cochrane Central Register of Controlled Trials were searched for relevant peer-reviewed articles published up to May 3, 2024. Three random-effects models were performed, when appropriate, to evaluate the relationship between Mg and cognitive outcomes: 1) linear meta-regression, 2) nonlinear (quadratic) meta-regression, and 3) meta-analysis using Mg variables categorized based on pre-existing recommendations. Three RCTs and 12 cohort studies were included in this systematic review. Evidence from the limited number of RCTs was insufficient to draw conclusions on the effects of Mg supplements. Cohort studies showed inconsistent dose-response relationships between dietary Mg and cognitive disorders, with high heterogeneity across populations. However, consistent U-shape associations of serum Mg with all-cause dementia and cognitive impairment were found in cohorts, suggesting an optimal serum Mg concentration of ∼0.85 mmol/L. This nonlinear association was detected in meta-regression (Pquadratic = 0.003) and in meta-analysis based on the reference interval of serum Mg (0.75-0.95 mmol/L) [<0.75 compared with 0.85 mmol/L: pooled hazard ratio (HR) = 1.43; 95% confidence interval (CI) = 1.05, 1.93; >0.95 compared with 0.85 mmol/L: pooled HR = 1.30; 95% CI = 1.03, 1.64]. More evidence from RCTs and cohorts is warranted. Future cohort studies should evaluate various Mg biomarkers and collect repeated measurements of Mg intake over time, considering different sources (diet or supplements) and factors affecting absorption (for example, calcium-to-Mg intake ratio). This systematic review was preregistered in PROSPERO (CRD42023423663).
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Affiliation(s)
- Fan Chen
- Department of Biomedical and Nutritional Sciences, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, MA, United States
| | - Jifan Wang
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Yijie Cheng
- Department of Nutrition, Brigham and Women's Hospital, Boston, MA, United States
| | - Ruogu Li
- Department of Rheumatology, Immunology & Allergy, Brigham and Women's Hospital, Boston, MA, United States
| | - Yifei Wang
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, United States
| | - Yutong Chen
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Tammy Scott
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Katherine L Tucker
- Department of Biomedical and Nutritional Sciences, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, MA, United States.
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Yang Z, Wei C, Li X, Yuan J, Gao X, Li B, Zhao Z, Toh S, Yu X, Brayne C, Yang Z, Sha F, Tang J. Association Between Regular Laxative Use and Incident Dementia in UK Biobank Participants. Neurology 2023; 100:e1702-e1711. [PMID: 36813729 PMCID: PMC10115504 DOI: 10.1212/wnl.0000000000207081] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 01/06/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The use of over-the-counter laxatives is common in the general population. The microbiome-gut-brain axis hypothesis suggests that the use of laxatives could be associated with dementia. We aimed to examine the association between the regular use of laxatives and the incidence of dementia in UK Biobank participants. METHODS This prospective cohort study was based on UK Biobank participants aged 40-69 years without a history of dementia. Regular use of laxatives was defined as self-reported use in most days of the week for the last 4 weeks at baseline (2006-2010). The outcomes were all-cause dementia, Alzheimer disease (AD), and vascular dementia (VD), identified from linked hospital admissions or death registers (up to 2019). Sociodemographic characteristics, lifestyle factors, medical conditions, family history, and regular medication use were adjusted for in the multivariable Cox regression analyses. RESULTS Among the 502,229 participants with a mean age of 56.5 (SD 8.1) years at baseline, 273,251 (54.4%) were female, and 18,235 (3.6%) reported regular use of laxatives. Over a mean follow-up of 9.8 years, 218 (1.3%) participants with regular use of laxatives and 1,969 (0.4%) with no regular use developed all-cause dementia. Multivariable analyses showed that regular use of laxatives was associated with increased risk of all-cause dementia (hazard ratio [HR] 1.51; 95% CI 1.30-1.75) and VD (HR 1.65; 95% CI 1.21-2.27), with no significant association observed for AD (HR 1.05; 95% CI 0.79-1.40). The risk of both all-cause dementia and VD increased with the number of regularly used laxative types (p trend 0.001 and 0.04, respectively). Among the participants who clearly reported that they were using just 1 type of laxative (n = 5,800), only those using osmotic laxatives showed a statistically significantly higher risk of all-cause dementia (HR 1.64; 95% CI 1.20-2.24) and VD (HR 1.97; 95% CI 1.04-3.75). These results remained robust in various subgroup and sensitivity analyses. DISCUSSION Regular use of laxatives was associated with a higher risk of all-cause dementia, particularly in those who used multiple laxative types or osmotic laxative.
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Affiliation(s)
- Zhirong Yang
- From the Shenzhen Institute of Advanced Technology (Zhirong Yang, C.W., Z.Z., F.S., J.T.), Chinese Academy of Sciences, Guangdong, China; Primary Care Unit (Zhirong Yang), School of Clinical Medicine, University of Cambridge, United Kingdom; Department of Population Medicine (X.L., S.T.), Harvard Medical School & Harvard Pilgrim Health Care Institute, Boston, MA; Center for Digestive Disease (J.Y.), The Seventh Affiliated Hospital, Sun Yat-sen University; Central Laboratory (X.G.), Shenzhen Key Laboratory of Precision Medicine for Hematological Malignancies, Shenzhen University General Hospital; School of Government (B.L.), Shenzhen University, Guangdong; Peking University Sixth Hospital (X.Y.), Peking University Institute of Mental Health, Beijing, China; Cambridge Public Health (C.B.), School of Clinical Medicine, University of Cambridge, United Kingdom; Division of Epidemiology (Zuyao Yang, J.T.), The JC School of Public Health & Primary Care, The Chinese University of Hong Kong; and Clinical Data Center (J.T.), Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China.
| | - Chang Wei
- From the Shenzhen Institute of Advanced Technology (Zhirong Yang, C.W., Z.Z., F.S., J.T.), Chinese Academy of Sciences, Guangdong, China; Primary Care Unit (Zhirong Yang), School of Clinical Medicine, University of Cambridge, United Kingdom; Department of Population Medicine (X.L., S.T.), Harvard Medical School & Harvard Pilgrim Health Care Institute, Boston, MA; Center for Digestive Disease (J.Y.), The Seventh Affiliated Hospital, Sun Yat-sen University; Central Laboratory (X.G.), Shenzhen Key Laboratory of Precision Medicine for Hematological Malignancies, Shenzhen University General Hospital; School of Government (B.L.), Shenzhen University, Guangdong; Peking University Sixth Hospital (X.Y.), Peking University Institute of Mental Health, Beijing, China; Cambridge Public Health (C.B.), School of Clinical Medicine, University of Cambridge, United Kingdom; Division of Epidemiology (Zuyao Yang, J.T.), The JC School of Public Health & Primary Care, The Chinese University of Hong Kong; and Clinical Data Center (J.T.), Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China
| | - Xiaojuan Li
- From the Shenzhen Institute of Advanced Technology (Zhirong Yang, C.W., Z.Z., F.S., J.T.), Chinese Academy of Sciences, Guangdong, China; Primary Care Unit (Zhirong Yang), School of Clinical Medicine, University of Cambridge, United Kingdom; Department of Population Medicine (X.L., S.T.), Harvard Medical School & Harvard Pilgrim Health Care Institute, Boston, MA; Center for Digestive Disease (J.Y.), The Seventh Affiliated Hospital, Sun Yat-sen University; Central Laboratory (X.G.), Shenzhen Key Laboratory of Precision Medicine for Hematological Malignancies, Shenzhen University General Hospital; School of Government (B.L.), Shenzhen University, Guangdong; Peking University Sixth Hospital (X.Y.), Peking University Institute of Mental Health, Beijing, China; Cambridge Public Health (C.B.), School of Clinical Medicine, University of Cambridge, United Kingdom; Division of Epidemiology (Zuyao Yang, J.T.), The JC School of Public Health & Primary Care, The Chinese University of Hong Kong; and Clinical Data Center (J.T.), Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China
| | - Jinqiu Yuan
- From the Shenzhen Institute of Advanced Technology (Zhirong Yang, C.W., Z.Z., F.S., J.T.), Chinese Academy of Sciences, Guangdong, China; Primary Care Unit (Zhirong Yang), School of Clinical Medicine, University of Cambridge, United Kingdom; Department of Population Medicine (X.L., S.T.), Harvard Medical School & Harvard Pilgrim Health Care Institute, Boston, MA; Center for Digestive Disease (J.Y.), The Seventh Affiliated Hospital, Sun Yat-sen University; Central Laboratory (X.G.), Shenzhen Key Laboratory of Precision Medicine for Hematological Malignancies, Shenzhen University General Hospital; School of Government (B.L.), Shenzhen University, Guangdong; Peking University Sixth Hospital (X.Y.), Peking University Institute of Mental Health, Beijing, China; Cambridge Public Health (C.B.), School of Clinical Medicine, University of Cambridge, United Kingdom; Division of Epidemiology (Zuyao Yang, J.T.), The JC School of Public Health & Primary Care, The Chinese University of Hong Kong; and Clinical Data Center (J.T.), Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China
| | - Xuefeng Gao
- From the Shenzhen Institute of Advanced Technology (Zhirong Yang, C.W., Z.Z., F.S., J.T.), Chinese Academy of Sciences, Guangdong, China; Primary Care Unit (Zhirong Yang), School of Clinical Medicine, University of Cambridge, United Kingdom; Department of Population Medicine (X.L., S.T.), Harvard Medical School & Harvard Pilgrim Health Care Institute, Boston, MA; Center for Digestive Disease (J.Y.), The Seventh Affiliated Hospital, Sun Yat-sen University; Central Laboratory (X.G.), Shenzhen Key Laboratory of Precision Medicine for Hematological Malignancies, Shenzhen University General Hospital; School of Government (B.L.), Shenzhen University, Guangdong; Peking University Sixth Hospital (X.Y.), Peking University Institute of Mental Health, Beijing, China; Cambridge Public Health (C.B.), School of Clinical Medicine, University of Cambridge, United Kingdom; Division of Epidemiology (Zuyao Yang, J.T.), The JC School of Public Health & Primary Care, The Chinese University of Hong Kong; and Clinical Data Center (J.T.), Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China
| | - Bingyu Li
- From the Shenzhen Institute of Advanced Technology (Zhirong Yang, C.W., Z.Z., F.S., J.T.), Chinese Academy of Sciences, Guangdong, China; Primary Care Unit (Zhirong Yang), School of Clinical Medicine, University of Cambridge, United Kingdom; Department of Population Medicine (X.L., S.T.), Harvard Medical School & Harvard Pilgrim Health Care Institute, Boston, MA; Center for Digestive Disease (J.Y.), The Seventh Affiliated Hospital, Sun Yat-sen University; Central Laboratory (X.G.), Shenzhen Key Laboratory of Precision Medicine for Hematological Malignancies, Shenzhen University General Hospital; School of Government (B.L.), Shenzhen University, Guangdong; Peking University Sixth Hospital (X.Y.), Peking University Institute of Mental Health, Beijing, China; Cambridge Public Health (C.B.), School of Clinical Medicine, University of Cambridge, United Kingdom; Division of Epidemiology (Zuyao Yang, J.T.), The JC School of Public Health & Primary Care, The Chinese University of Hong Kong; and Clinical Data Center (J.T.), Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China
| | - Ziyi Zhao
- From the Shenzhen Institute of Advanced Technology (Zhirong Yang, C.W., Z.Z., F.S., J.T.), Chinese Academy of Sciences, Guangdong, China; Primary Care Unit (Zhirong Yang), School of Clinical Medicine, University of Cambridge, United Kingdom; Department of Population Medicine (X.L., S.T.), Harvard Medical School & Harvard Pilgrim Health Care Institute, Boston, MA; Center for Digestive Disease (J.Y.), The Seventh Affiliated Hospital, Sun Yat-sen University; Central Laboratory (X.G.), Shenzhen Key Laboratory of Precision Medicine for Hematological Malignancies, Shenzhen University General Hospital; School of Government (B.L.), Shenzhen University, Guangdong; Peking University Sixth Hospital (X.Y.), Peking University Institute of Mental Health, Beijing, China; Cambridge Public Health (C.B.), School of Clinical Medicine, University of Cambridge, United Kingdom; Division of Epidemiology (Zuyao Yang, J.T.), The JC School of Public Health & Primary Care, The Chinese University of Hong Kong; and Clinical Data Center (J.T.), Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China
| | - Sengwee Toh
- From the Shenzhen Institute of Advanced Technology (Zhirong Yang, C.W., Z.Z., F.S., J.T.), Chinese Academy of Sciences, Guangdong, China; Primary Care Unit (Zhirong Yang), School of Clinical Medicine, University of Cambridge, United Kingdom; Department of Population Medicine (X.L., S.T.), Harvard Medical School & Harvard Pilgrim Health Care Institute, Boston, MA; Center for Digestive Disease (J.Y.), The Seventh Affiliated Hospital, Sun Yat-sen University; Central Laboratory (X.G.), Shenzhen Key Laboratory of Precision Medicine for Hematological Malignancies, Shenzhen University General Hospital; School of Government (B.L.), Shenzhen University, Guangdong; Peking University Sixth Hospital (X.Y.), Peking University Institute of Mental Health, Beijing, China; Cambridge Public Health (C.B.), School of Clinical Medicine, University of Cambridge, United Kingdom; Division of Epidemiology (Zuyao Yang, J.T.), The JC School of Public Health & Primary Care, The Chinese University of Hong Kong; and Clinical Data Center (J.T.), Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China
| | - Xin Yu
- From the Shenzhen Institute of Advanced Technology (Zhirong Yang, C.W., Z.Z., F.S., J.T.), Chinese Academy of Sciences, Guangdong, China; Primary Care Unit (Zhirong Yang), School of Clinical Medicine, University of Cambridge, United Kingdom; Department of Population Medicine (X.L., S.T.), Harvard Medical School & Harvard Pilgrim Health Care Institute, Boston, MA; Center for Digestive Disease (J.Y.), The Seventh Affiliated Hospital, Sun Yat-sen University; Central Laboratory (X.G.), Shenzhen Key Laboratory of Precision Medicine for Hematological Malignancies, Shenzhen University General Hospital; School of Government (B.L.), Shenzhen University, Guangdong; Peking University Sixth Hospital (X.Y.), Peking University Institute of Mental Health, Beijing, China; Cambridge Public Health (C.B.), School of Clinical Medicine, University of Cambridge, United Kingdom; Division of Epidemiology (Zuyao Yang, J.T.), The JC School of Public Health & Primary Care, The Chinese University of Hong Kong; and Clinical Data Center (J.T.), Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China
| | - Carol Brayne
- From the Shenzhen Institute of Advanced Technology (Zhirong Yang, C.W., Z.Z., F.S., J.T.), Chinese Academy of Sciences, Guangdong, China; Primary Care Unit (Zhirong Yang), School of Clinical Medicine, University of Cambridge, United Kingdom; Department of Population Medicine (X.L., S.T.), Harvard Medical School & Harvard Pilgrim Health Care Institute, Boston, MA; Center for Digestive Disease (J.Y.), The Seventh Affiliated Hospital, Sun Yat-sen University; Central Laboratory (X.G.), Shenzhen Key Laboratory of Precision Medicine for Hematological Malignancies, Shenzhen University General Hospital; School of Government (B.L.), Shenzhen University, Guangdong; Peking University Sixth Hospital (X.Y.), Peking University Institute of Mental Health, Beijing, China; Cambridge Public Health (C.B.), School of Clinical Medicine, University of Cambridge, United Kingdom; Division of Epidemiology (Zuyao Yang, J.T.), The JC School of Public Health & Primary Care, The Chinese University of Hong Kong; and Clinical Data Center (J.T.), Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China
| | - Zuyao Yang
- From the Shenzhen Institute of Advanced Technology (Zhirong Yang, C.W., Z.Z., F.S., J.T.), Chinese Academy of Sciences, Guangdong, China; Primary Care Unit (Zhirong Yang), School of Clinical Medicine, University of Cambridge, United Kingdom; Department of Population Medicine (X.L., S.T.), Harvard Medical School & Harvard Pilgrim Health Care Institute, Boston, MA; Center for Digestive Disease (J.Y.), The Seventh Affiliated Hospital, Sun Yat-sen University; Central Laboratory (X.G.), Shenzhen Key Laboratory of Precision Medicine for Hematological Malignancies, Shenzhen University General Hospital; School of Government (B.L.), Shenzhen University, Guangdong; Peking University Sixth Hospital (X.Y.), Peking University Institute of Mental Health, Beijing, China; Cambridge Public Health (C.B.), School of Clinical Medicine, University of Cambridge, United Kingdom; Division of Epidemiology (Zuyao Yang, J.T.), The JC School of Public Health & Primary Care, The Chinese University of Hong Kong; and Clinical Data Center (J.T.), Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China.
| | - Feng Sha
- From the Shenzhen Institute of Advanced Technology (Zhirong Yang, C.W., Z.Z., F.S., J.T.), Chinese Academy of Sciences, Guangdong, China; Primary Care Unit (Zhirong Yang), School of Clinical Medicine, University of Cambridge, United Kingdom; Department of Population Medicine (X.L., S.T.), Harvard Medical School & Harvard Pilgrim Health Care Institute, Boston, MA; Center for Digestive Disease (J.Y.), The Seventh Affiliated Hospital, Sun Yat-sen University; Central Laboratory (X.G.), Shenzhen Key Laboratory of Precision Medicine for Hematological Malignancies, Shenzhen University General Hospital; School of Government (B.L.), Shenzhen University, Guangdong; Peking University Sixth Hospital (X.Y.), Peking University Institute of Mental Health, Beijing, China; Cambridge Public Health (C.B.), School of Clinical Medicine, University of Cambridge, United Kingdom; Division of Epidemiology (Zuyao Yang, J.T.), The JC School of Public Health & Primary Care, The Chinese University of Hong Kong; and Clinical Data Center (J.T.), Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China.
| | - Jinling Tang
- From the Shenzhen Institute of Advanced Technology (Zhirong Yang, C.W., Z.Z., F.S., J.T.), Chinese Academy of Sciences, Guangdong, China; Primary Care Unit (Zhirong Yang), School of Clinical Medicine, University of Cambridge, United Kingdom; Department of Population Medicine (X.L., S.T.), Harvard Medical School & Harvard Pilgrim Health Care Institute, Boston, MA; Center for Digestive Disease (J.Y.), The Seventh Affiliated Hospital, Sun Yat-sen University; Central Laboratory (X.G.), Shenzhen Key Laboratory of Precision Medicine for Hematological Malignancies, Shenzhen University General Hospital; School of Government (B.L.), Shenzhen University, Guangdong; Peking University Sixth Hospital (X.Y.), Peking University Institute of Mental Health, Beijing, China; Cambridge Public Health (C.B.), School of Clinical Medicine, University of Cambridge, United Kingdom; Division of Epidemiology (Zuyao Yang, J.T.), The JC School of Public Health & Primary Care, The Chinese University of Hong Kong; and Clinical Data Center (J.T.), Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China
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Feng J, Zheng N, Fan X, Li S, Jiang Y, Yi X, Yang H. Association of laxatives use with incident dementia and modifying effect of genetic susceptibility: a population-based cohort study with propensity score matching. BMC Geriatr 2023; 23:122. [PMID: 36870957 PMCID: PMC9985868 DOI: 10.1186/s12877-023-03854-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 02/28/2023] [Indexed: 03/06/2023] Open
Abstract
BACKGROUND Constipation was associated with incidence of dementia and cognitive decline. Laxatives are the mainstay of constipation management and are commonly used among older populations for both treatment and prevention of constipation. However, the association between use of laxatives and incident dementia, and whether laxatives use may modify the effect of genetic predisposition on dementia remains unclear. METHODS We applied 1:3 propensity score matching to balance the baseline characteristics of the laxative users versus non-users and to reduce potential confounders using multi-variates adjusted Cox hazards regression models. We categorized genetic risk into three groups (low, middle, and high) through a genetic risk score of common genetic variants. Information on laxatives use was assessed at baseline and categories into four varieties, including bulk forming laxatives, softeners and emollients, osmotic laxatives, and stimulant laxatives. RESULTS Of 486,994 participants, there were 14,422 laxatives users in UK Biobank. After propensity score matching, participants with use of laxatives (n = 14,422) and matched non-laxative (n = 43,266) exposed individuals were enrolled. Over follow-up to 15 years, there were 1377 participants developed dementia (539 for Alzheimer's disease, and 343 for vascular dementia). The use of laxatives had greater risk of dementia (HR, 1.72; 95% CI:1.54-1.92), Alzheimer's disease (HR, 1.36; 95% CI: 1.13-1.63), and vascular dementia (HR, 1.53; 95% CI: 1.23-1.92). Compared to non-laxative exposed participants, those with use of softeners and emollients drugs, stimulant laxatives, and osmotic laxatives were associated with 96% (HR, 1.96; 95 CI: 1.23-3.12; P = 0.005), 80% (HR, 1.80; 95% CI: 1.37-2.37; P < 0.001), and 107% (HR, 2.07; 95% CI: 1.47-2.92; P < 0.001) higher risk of developed incident dementia, respectively. In joint effect analysis, compared to participants with low/middle genetic susceptibility and non-laxatives use, the HR (95% CIs) of dementia was 4.10 (3.49-4.81) for those with high genetic susceptibility plus use of laxatives. There was an additive interaction between laxatives use and genetic susceptibility on dementia (RERI: 0.736, 95% CI: 0.127 to 1.246; AP: 0.180, 95% CI: 0.047 to 0.312). CONCLUSIONS Use of laxatives was associated with higher risk of dementia and modify the effect of genetic susceptibility on dementia. Our findings suggested that attention should be paid to the relationship between laxatives use and dementia, especially in people at high genetic susceptibility.
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Affiliation(s)
- Jiangtao Feng
- Department of Orthopedics, Tianjin NanKai Hospital, Tianjin, 300100, China
| | - Nan Zheng
- Department of Network Security and Informatization, Tianjin Medical University, Tianjin, 300070, China
| | - Xutong Fan
- Department of Bioinformatics, School of Basic Medical Sciences, Tianjin Medical University, Qixiangtai Road 22, Heping District, Tianjin, 300070, China
| | - Shu Li
- School of Management, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China
| | - Yuhan Jiang
- Department of Bioinformatics, School of Basic Medical Sciences, Tianjin Medical University, Qixiangtai Road 22, Heping District, Tianjin, 300070, China
| | - Xianfu Yi
- Department of Bioinformatics, School of Basic Medical Sciences, Tianjin Medical University, Qixiangtai Road 22, Heping District, Tianjin, 300070, China
| | - Hongxi Yang
- Department of Bioinformatics, School of Basic Medical Sciences, Tianjin Medical University, Qixiangtai Road 22, Heping District, Tianjin, 300070, China. .,Department of Pharmacology, Tianjin Key Laboratory of Inflammation Biology, School of Basic Medical Sciences, Tianjin Medical University, Qixiangtai Road 22, Heping District, Tianjin, 300070, China.
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Luo J, Zhang C, Zhao Q, Wu W, Liang X, Xiao Z, Mortimer JA, Borenstein AR, Dai Q, Ding D. Dietary calcium and magnesium intake and risk for incident dementia: The Shanghai Aging Study. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2022; 8:e12362. [PMID: 36478774 PMCID: PMC9721293 DOI: 10.1002/trc2.12362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 09/30/2022] [Accepted: 10/01/2022] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Calcium (Ca), magnesium (Mg), or the calcium to magnesium (Ca:Mg) ratio may affect the risk of dementia via complex mechanisms. The aim of this study was to evaluate the association of dietary Ca, Mg, and Ca:Mg ratio with dementia risk at the prospective phase of the Shanghai Aging Study. METHODS We analyzed data from 1565 dementia-free participants living in an urban community who had measurements of dietary Ca and Mg intake derived from a food frequency questionnaire at baseline and incident dementia during follow-up. RESULTS Over the 5-year follow-up, 162 (10.4%) participants were diagnosed with incident dementia by Diagnostic and Statistical Manual of Mental Disorders, 4th edition criteria. Participants with the lowest tertile of dietary Ca (<339.1 mg/day) and Mg (<202.1 mg/day) had the highest incidence rates of dementia (3.3/100 person-years for Ca, 3.3/100 person-years for Mg) compared to those with higher Ca and Mg intake. In the subgroup with Ca:Mg ratios ≤ 1.69, Mg intake >267.5 mg/day was related to an increased risk for dementia (adjusted hazard ratio: 3.97, 95% confidence interval: 1.29-12.25). CONCLUSIONS Our findings suggest that high dietary intake of Mg is associated with an increased risk of dementia mainly among older adults with low Ca:Mg intake ratios. Proper balance of Ca to Mg in the diet may be critical to the relationship between Mg intake and risk of dementia. HIGHLIGHTS Participants with the lowest tertile of dietary calcium (Ca) and magnesium (Mg) had the highest incidence rates of dementia.In the subgroup with Ca:Mg ratios ≤1.69, Mg intake >267.5 mg/day was related to an increased risk for dementia.Balance of Ca to Mg in diet may be critical to the relationship between Mg intake and risk of dementia.
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Affiliation(s)
- Jianfeng Luo
- Department of BiostatisticsSchool of Public HealthFudan UniversityShanghaiChina,NHC Key Laboratory of Health Technology AssessmentFudan UniversityShanghaiChina,Key Laboratory of Public Health Safety of Ministry of EducationFudan UniversityShanghaiChina
| | - Chenbo Zhang
- Department of BiostatisticsSchool of Public HealthFudan UniversityShanghaiChina,NHC Key Laboratory of Health Technology AssessmentFudan UniversityShanghaiChina,Key Laboratory of Public Health Safety of Ministry of EducationFudan UniversityShanghaiChina
| | - Qianhua Zhao
- Institute of NeurologyHuashan HospitalFudan UniversityShanghaiChina,National Clinical Research Center for Aging and MedicineHuashan HospitalFudan UniversityShanghaiChina
| | - Wanqing Wu
- Institute of NeurologyHuashan HospitalFudan UniversityShanghaiChina,National Clinical Research Center for Aging and MedicineHuashan HospitalFudan UniversityShanghaiChina
| | - Xiaoniu Liang
- Institute of NeurologyHuashan HospitalFudan UniversityShanghaiChina,National Clinical Research Center for Aging and MedicineHuashan HospitalFudan UniversityShanghaiChina
| | - Zhenxu Xiao
- Institute of NeurologyHuashan HospitalFudan UniversityShanghaiChina,National Clinical Research Center for Aging and MedicineHuashan HospitalFudan UniversityShanghaiChina
| | | | - Amy R. Borenstein
- School of Public Health and Human LongevityUniversity of California‐San DiegoLa JollaCaliforniaUSA
| | - Qi Dai
- Department of MedicineVanderbilt Epidemiology CenterVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Ding Ding
- Institute of NeurologyHuashan HospitalFudan UniversityShanghaiChina,National Clinical Research Center for Aging and MedicineHuashan HospitalFudan UniversityShanghaiChina
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Wu CH, Peng CK, Chung CH, Chien WC, Tzeng NS. Real-World Evidence for the Association Between Pneumonia-Related Intensive Care Unit Stay and Dementia. Psychiatry Investig 2022; 19:247-258. [PMID: 35500898 PMCID: PMC9058270 DOI: 10.30773/pi.2021.0277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 01/27/2022] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE There is limited clarity concerning the risk of dementia after pneumonia with intensive care unit (ICU) stay. We conducted a nationwide cohort study, which aimed to investigate the impact of dementia after pneumonia with and without intensive care unit admission. METHODS Data was obtained from Taiwan's National Health Insurance Research Database between 2000 and 2015. A total of 7,473 patients were identified as having pneumonia required ICU stay, along with 22,419 controls matched by sex and age. After adjusting for confounding factors, multivariate Cox regression model analysis was used to compare the risk of developing dementia during the 15-years follow-up period. RESULTS The enrolled pneumonia patients with ICU admission had a dementia rate of 9.89%. Pneumonia patients without ICU admission had a dementia rate of 9.21%. The multivariate Cox regression model analysis revealed that the patients with ICU stay had the higher risk of dementia, with a crude hazard ratio of 3.371 (95% confidence interval, 3.093-3.675; p<0.001). CONCLUSION This study indicated that pneumonia with ICU stay is associated with an increased risk of dementia. A 3-fold risk of dementia was observed in patients admitted to the ICU compared to the control group.
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Affiliation(s)
- Chun-Han Wu
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Chung-Kan Peng
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Chi-Hsian Chung
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan.,School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan.,School of Public Health, National Defense Medical Center, Taipei, Taiwan.,Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Nian-Sheng Tzeng
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Student Counseling Center, National Defense Medical Center, Taipei, Taiwan
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6
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Yang CC, Chien WC, Chung CH, Lai CY, Tzeng NS. The Usage of Histamine Type 1 Receptor Antagonist and Risk of Dementia in the Elderly: A Nationwide Cohort Study. Front Aging Neurosci 2022; 14:811494. [PMID: 35370616 PMCID: PMC8972197 DOI: 10.3389/fnagi.2022.811494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 01/21/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThe histamine type 1 receptor antagonist (H1RA) has been commonly used. This study aimed to examine the association between the usage of H1RA and the risk of dementia.MethodsA total of 8,986 H1RA users aged ≥50 and 26,958 controls matched a ratio of 1:3 for age, sex, and comorbidity, were selected between January 1, and December 31, 2000, from Taiwan’s National Health Insurance Research Database. Fine and Gray’s survival analysis (competing with mortality) was used to compare the risk of developing dementia during a 15-year follow-up period (2000–2015).ResultsIn general, the H1RA usage was not significantly associated with dementia (adjusted subdistribution hazard ratio [SHR] = 1.025, 95% confidence interval [CI] = 0.883–1.297, p = 0.274) for the H1RA cohort. However, a differential risk was found among the groups at risk. The patients with the usage of H1RA aged ≥65 years (adjusted SHR: 1.782, 95% CI = 1.368–2.168, p < 0.001) were associated with a higher risk of dementia, in comparison to the control groups. Furthermore, the patients with the usage of H1RA that were male, or had more comorbidities, were also associated with an increased risk of dementia.ConclusionThe usage of H1RA was associated with the risk of developing dementia in the patients aged ≥ 65 years.
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Affiliation(s)
- Chuan-Chi Yang
- Department of Psychiatry, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan
- Department of Psychiatry, Taoyuan Armed Forces General Hospital, Hsinchu Branch, Hsinchu City, Taiwan
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
- Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan
| | - Chi-Hsiang Chung
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
- Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan
| | - Chung-Yu Lai
- Graduate Institute of Aerospace and Undersea Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Nian-Sheng Tzeng
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
- Student Counseling Center, National Defense Medical Center, Taipei, Taiwan
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7
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Tao M, Liu J, Cervantes D. Association between magnesium intake and cognition in US older adults: National Health and Nutrition Examination Survey (NHANES) 2011 to 2014. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2022; 8:e12250. [PMID: 35128033 PMCID: PMC8804621 DOI: 10.1002/trc2.12250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 11/28/2021] [Accepted: 12/15/2021] [Indexed: 11/10/2022]
Abstract
INTRODUCTION Identifying nutrition- and modifiable lifestyle-based risk factors for cognitive decline and dementia may contribute future primary prevention strategies. This study aimed to evaluate the associations between magnesium intake and cognition in older adults in the United States. METHODS Based on the National Health and Nutrition Survey (NHANES) between 2011 and 2014, the study included 2508 participants aged 60 years and older. Linear regression models were used to examine the association of total magnesium intake with cognition. RESULTS After adjusted demographic and other confounding factors, intakes of energy and total calcium, and serum vitamin D level, higher intake of total magnesium was independently associated with 0.15 higher global cognitive z-score (95% confidence interval, 0.02 to 0.28 for highest vs. lowest quartile, P trend = .037). The positive association of total magnesium intake with global cognition was primarily presented among women, non-Hispanic Whites, and those with sufficient serum vitamin D levels (≥50 nmol/L), although interactions were not significant. There were no clear linear associations for global cognition with serum vitamin D level. DISCUSSIONS Our findings suggest that high magnesium intake alone may improve cognition in older adults, particularly among non-Hispanic Whites and subjects with sufficient levels of serum vitamin D. Further studies are needed to confirm the findings.
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Affiliation(s)
- Meng‐Hua Tao
- Department of Biostatistics and EpidemiologyUniversity of North Texas Health Science CenterFort WorthTexasUSA
| | - Jialiang Liu
- Department of Epidemiology and BiostatisticsCollege of Public HealthTemple UniversityPhiladelphiaPennsylvaniaUSA
| | - Diana Cervantes
- Department of Biostatistics and EpidemiologyUniversity of North Texas Health Science CenterFort WorthTexasUSA
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8
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Yang HY, Chien WC, Chung CH, Su RY, Lai CY, Yang CC, Tzeng NS. Risk of dementia in patients with toxoplasmosis: a nationwide, population-based cohort study in Taiwan. Parasit Vectors 2021; 14:435. [PMID: 34454590 PMCID: PMC8401101 DOI: 10.1186/s13071-021-04928-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 08/05/2021] [Indexed: 01/01/2023] Open
Abstract
Background Approximately 25–30% of individuals worldwide are infected with Toxoplasma gondii (T. gondii), which is difficult to detect in its latent state. We aimed to evaluate the association between toxoplasmosis, the risk of dementia, and the effects of antibiotics in Taiwan. Methods This nationwide, population-based, retrospective cohort study was conducted using the Longitudinal Health Insurance Database containing the records of 2 million individuals retrieved from Taiwan’s National Health Insurance Research Database. Fine–Gray competing risk analysis was used to determine the risk for the development of dementia in the toxoplasmosis cohort relative to the non-toxoplasmosis cohort. A sensitivity analysis was also conducted. The effects of antibiotics (sulfadiazine or clindamycin) on the risk of dementia were also analyzed. Results We enrolled a total of 800 subjects, and identified 200 patients with toxoplasmosis and 600 sex- and age-matched controls without toxoplasmosis infection in a ratio of 1:3, selected between 2000 and 2015. The crude hazard ratio (HR) of the risk of developing dementia was 2.570 [95% confidence interval (CI) = 1.511–4.347, P < 0.001]. After adjusting for sex, age, monthly insurance premiums, urbanization level, geographical region, and comorbidities, the adjusted HR was 2.878 (95% CI = 1.709–4.968, P < 0.001). Sensitivity analysis revealed that toxoplasmosis was associated with the risk of dementia even after excluding diagnosis in the first year and the first 5 years. The usage of sulfadiazine or clindamycin in the treatment of toxoplasmosis was associated with a decreased risk of dementia. Conclusions This finding supports the evidence that toxoplasmosis is associated with dementia and that antibiotic treatment against toxoplasmosis is associated with a reduced risk of dementia. Further studies are necessary to explore the underlying mechanisms of these associations. Graphical Abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s13071-021-04928-7.
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Affiliation(s)
- Hung-Yi Yang
- Division of Clinical Pathology, Department of Pathology, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,School of Public Health, National Defense Medical Center, Taipei, Taiwan.,Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan.,Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan
| | - Chi-Hsiang Chung
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,School of Public Health, National Defense Medical Center, Taipei, Taiwan.,Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan
| | - Ruei-Yu Su
- Division of Clinical Pathology, Department of Pathology, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Chung-Yu Lai
- Graduate Institute of Aerospace and Undersea Medicine, School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Chuan-Chi Yang
- Department of Psychiatry, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan.,Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Nian-Sheng Tzeng
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan. .,Student Counseling Center, National Defense Medical Center, Taipei, Taiwan.
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9
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McCarty MF, DiNicolantonio JJ, Lerner A. A Fundamental Role for Oxidants and Intracellular Calcium Signals in Alzheimer's Pathogenesis-And How a Comprehensive Antioxidant Strategy May Aid Prevention of This Disorder. Int J Mol Sci 2021; 22:2140. [PMID: 33669995 PMCID: PMC7926325 DOI: 10.3390/ijms22042140] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 02/16/2021] [Accepted: 02/18/2021] [Indexed: 12/13/2022] Open
Abstract
Oxidative stress and increased cytoplasmic calcium are key mediators of the detrimental effects on neuronal function and survival in Alzheimer's disease (AD). Pathways whereby these perturbations arise, and then prevent dendritic spine formation, promote tau hyperphosphorylation, further amplify amyloid β generation, and induce neuronal apoptosis, are described. A comprehensive program of nutraceutical supplementation, comprised of the NADPH oxidase inhibitor phycocyanobilin, phase two inducers, the mitochondrial antioxidant astaxanthin, and the glutathione precursor N-acetylcysteine, may have important potential for antagonizing the toxic effects of amyloid β on neurons and thereby aiding prevention of AD. Moreover, nutraceutical antioxidant strategies may oppose the adverse impact of amyloid β oligomers on astrocyte clearance of glutamate, and on the ability of brain capillaries to export amyloid β monomers/oligomers from the brain. Antioxidants, docosahexaenoic acid (DHA), and vitamin D, have potential for suppressing microglial production of interleukin-1β, which potentiates the neurotoxicity of amyloid β. Epidemiology suggests that a health-promoting lifestyle, incorporating a prudent diet, regular vigorous exercise, and other feasible measures, can cut the high risk for AD among the elderly by up to 60%. Conceivably, complementing such lifestyle measures with long-term adherence to the sort of nutraceutical regimen outlined here may drive down risk for AD even further.
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Affiliation(s)
| | | | - Aaron Lerner
- Chaim Sheba Medical Center, The Zabludowicz Research Center for Autoimmune Diseases, Tel Hashomer 5262000, Israel
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10
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Low Serum Magnesium is Associated with Incident Dementia in the ARIC-NCS Cohort. Nutrients 2020; 12:nu12103074. [PMID: 33050118 PMCID: PMC7600951 DOI: 10.3390/nu12103074] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 10/01/2020] [Accepted: 10/01/2020] [Indexed: 01/02/2023] Open
Abstract
Higher serum magnesium is associated with lower risk of multiple morbidities, including diabetes, stroke, and atrial fibrillation, but its potential neuroprotective properties have also been gaining traction in cognitive function and decline research. We studied 12,040 participants presumed free of dementia in the Atherosclerosis Risk in Communities (ARIC) study. Serum magnesium was measured in fasting blood samples collected in 1990–1992. Dementia status was ascertained through cognitive examinations in 2011–2013, 2016–2017, and 2018–2019, along with informant interviews and indicators of dementia-related hospitalization events and death. Participants’ cognitive functioning capabilities were assessed up to five times between 1990–1992 and 2018–2019. The cognitive function of participants who did not attend follow-up study visits was imputed to account for attrition. We identified 2519 cases of dementia over a median follow-up period of 24.2 years. The lowest quintile of serum magnesium was associated with a 24% higher rate of incident dementia compared to those in the highest quintile of magnesium (HR, 1.24; 95% CI, 1.07, 1.44). No relationship was found between serum magnesium and cognitive decline in any cognitive domain. Low midlife serum magnesium is associated with increased risk of incident dementia, but does not appear to impact rates of cognitive decline.
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11
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Hussain S, Singh A, Zameer S, Jamali MC, Baxi H, Rahman SO, Alam M, Altamish M, Singh AK, Anil D, Hussain MS, Ahmad A, Najmi AK. No association between proton pump inhibitor use and risk of dementia: Evidence from a meta-analysis. J Gastroenterol Hepatol 2020; 35:19-28. [PMID: 31334885 DOI: 10.1111/jgh.14789] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 06/30/2019] [Accepted: 07/16/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIM A growing body of literature suggests the association between dementia risk and proton pump inhibitor (PPI) use. Therefore, we aimed to investigate the association between PPI use and dementia risk. METHODS An extensive literature search was performed in PubMed, Embase, and Cochrane till March 31, 2019. All the studies (cohort and case-control) assessing the association between PPI use and dementia risk were eligible for inclusion. Articles were selected based on the screening of title and abstract, data were extracted, and risk of bias was assessed using Newcastle-Ottawa scale. The primary outcome was pooled risk of dementia among PPI user as compared with non-PPI user. Secondary outcomes include dementia risk based on subgroups. Statistical analysis was performed using review manager software. RESULTS Twelve studies (eight cohort and four case-control) were found to be eligible for inclusion. Majority of the studies were of high quality. Dementia was diagnosed based on International Classification of Diseases 9/10 codes in majority of the included studies. PPI use was not associated with the dementia risk, with a pooled relative risk (RR) of 1.05 (95% confidence interval [CI]: 0.96-1.15), P = 0.31. Subgroup analysis based on study design (cohort: P = 0.14; case-control: P = 0.14), sex (RR 1.25 [95% CI: 0.97-1.60], P = 0.08), histamine 2 receptor antagonist blockers (P = 0.93), and Alzheimer's disease (RR 1.00 [95% CI: 0.91-1.09], P = 0.93) revealed no significant association between PPI use and dementia risk. CONCLUSION We found no significant association between PPI use and the risk of dementia or Alzheimer's disease.
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Affiliation(s)
- Salman Hussain
- Department of Pharmaceutical Medicine (Division of Pharmacology), School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, India
| | - Ambrish Singh
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Saima Zameer
- Department of Pharmaceutical Medicine (Division of Pharmacology), School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, India
| | - Mohammad Chand Jamali
- Department of Health and Medical Sciences, Khawarizmi International College, Abu Dhabi, United Arab Emirates
| | - Harveen Baxi
- Department of Pharmacology, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, India
| | - Syed Obaidur Rahman
- Department of Pharmaceutical Medicine (Division of Pharmacology), School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, India
| | - Mahtab Alam
- Department of Pharmacology, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, India
| | - Mohammad Altamish
- Department of Pharmacology, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, India
| | - Avinash Kumar Singh
- Department of Pharmaceutical Medicine (Division of Pharmacology), School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, India
| | | | - Md Sarfaraj Hussain
- Institute of Pharmaceutical Sciences, Sanskriti University, Mathura, Uttar Pradesh, India
| | - Adil Ahmad
- Department of Pharmacognosy, Jamia Hamdard, New Delhi, India
| | - Abul Kalam Najmi
- Department of Pharmacology, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, India
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12
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Chiou YE, Chien WC, Chung CH, Chang HA, Kao YC, Tsay PK, Tzeng NS. New Users of Herbal Medicine Containing Aristolochic Acids and the Risk of Dementia in the Elderly: A Nationwide, Population-Based Study in Taiwan. Neuropsychiatr Dis Treat 2020; 16:1493-1504. [PMID: 32606702 PMCID: PMC7297452 DOI: 10.2147/ndt.s250659] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 05/22/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Herbal medicine containing aristolochic acids (HMCAA) was used for inflammatory and infectious diseases. This study aimed to investigate the association between the usage of HMCAA and the risk of dementia. METHODS A total of 199 new users of HMCAA were enrolled, along with 597 controls without the usage of HMCAA, at a ratio of 1:3 - matched by age, sex, and comorbidity, between 2000 and 2003 - from the National Health Research Institutes Database (NHRID) of Taiwan, which contains two million randomly sampled subjects, in this cohort study. We used Fine and Gray's survival analysis (competing with mortality) to compare the risk of developing dementia during a 15-year follow-up period (2000-2015). RESULTS In general, HMCAA was not significantly associated with dementia (adjusted subdistribution hazard ratio [SHR] = 0.861, 95% confidence interval [CI] = 0.484-1.532, p = 0.611) for the HMCAA-cohort, although differential risk was observed among the groups at risk. The patients with usage of HMCAA aged ≧ 85 years were associated with a higher risk in dementia (adjusted SHR: 6.243, 95% CI=1.258-21.084, p = 0.001), in comparison to those aged 50-54 years. Furthermore, the patients with usage of HMCAA that had cerebrovascular accidents were associated with an increased risk of dementia. CONCLUSION The usage of HMCAA was associated with the risk of developing dementia in the patients aged ≧ 85 years.
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Affiliation(s)
- Yueh-Er Chiou
- Department of Nursing, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.,Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,School of Public Health, National Defense Medical Center, Taipei, Taiwan.,Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Chi-Hsiang Chung
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,School of Public Health, National Defense Medical Center, Taipei, Taiwan.,Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan
| | - Hsin-An Chang
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Student Counseling Center, National Defense Medical Center, Taipei, Taiwan
| | - Yu-Chen Kao
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Department of Psychiatry, Tri-Service General Hospital, Song-Shan Branch, National Defense Medical Center, Taipei, Taiwan
| | - Pei-Kwei Tsay
- Department of Public Health and Center of Biostatistics, College of Medicine, Chang Gung University, Tao-Yuan 333, Taiwan
| | - Nian-Sheng Tzeng
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Student Counseling Center, National Defense Medical Center, Taipei, Taiwan
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13
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Lo K, Liu Q, Madsen T, Rapp S, Chen JC, Neuhouser M, Shadyab A, Pal L, Lin X, Shumaker S, Manson J, Feng YQ, Liu S. Relations of magnesium intake to cognitive impairment and dementia among participants in the Women's Health Initiative Memory Study: a prospective cohort study. BMJ Open 2019; 9:e030052. [PMID: 31685499 PMCID: PMC6858129 DOI: 10.1136/bmjopen-2019-030052] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 08/27/2019] [Accepted: 08/29/2019] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE To examine the associations of dietary and supplemental magnesium (Mg) as assessed by a semi-quantitative food frequency questionnaire with cognitive outcomes among ageing women. DESIGN This work conducts a prospective cohort study of participants enrolled in the Women's Health Initiative Memory Study (WHIMS), which was subsequently extended and named WHIMS-Epidemiology of Cognitive Health. SETTING Forty clinical centres in the USA. PARTICIPANTS Postmenopausal women aged 65-79 years without dementia on enrolment. MAIN OUTCOME MEASURES Physician-adjudicated mild cognitive impairment (MCI) and/or probable dementia (PD). RESULTS Participants were excluded (n=1006) if they had extreme values of dietary energy intake, had missing or extreme body mass index values, with prevalent MCI/PD at baseline, received only one cognitive assessment or had been followed up for <1 year. During >20 years of follow-up, 765 (11.8%) out of 6473 participants developed MCI/PD. For MCI/PD and MCI, the risks tended to be lower among participants in quintiles Q2-Q5 of Mg consumption compared with those in the lowest quintile. Participants in Q3 had a significantly lower risk of MCI/PD (HR 0.69, 95% CI 0.53 to 0.91) and MCI (HR 0.63, 95% CI 0.45 to 0.87) after multivariate adjustments. No significant association was observed between total Mg intake and PD. The association between total Mg intake, MCI/PD and MCI was non-linear as suggested by the likelihood test. CONCLUSIONS Total Mg intake between the estimated average requirement and the recommended dietary allowances may associate with a lower risk of MCI/PD and MCI. TRIAL REGISTRATION NUMBER NCT00685009.
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Affiliation(s)
- Kenneth Lo
- Department of Cardiology, Guangdong Cardiovascular Institute, Hypertension Research Laboratory, Guangdong Provincial People's Hospital, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Academy of Medical Sciences, South China University of Technology School of Medicine, Guangzhou, China
- Centre for Global Cardiometabolic Health, Department of Epidemiology, Brown University, Providence, Rhode Island, USA
| | - Qing Liu
- Centre for Global Cardiometabolic Health, Department of Epidemiology, Brown University, Providence, Rhode Island, USA
| | - Tracy Madsen
- Centre for Global Cardiometabolic Health, Department of Epidemiology, Brown University, Providence, Rhode Island, USA
- Department of Emergency Medicine, Alpert Medical School, Brown University, Providence, Rhode Island, USA
| | - Steve Rapp
- Wake Forest School of Medicine, Wake Forest University, Winston-Salem, North Carolina, USA
| | - Jiu-Chiuan Chen
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Marian Neuhouser
- Division of Public Health Sciences, Fred Hutchinson Cancer Original Research Center, Seattle, Washington, USA
| | - Aladdin Shadyab
- Department of Family and Preventive Medicine, University of California San Diego, La Jolla, California, USA
| | - Lubna Pal
- School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Xiaochen Lin
- Centre for Global Cardiometabolic Health, Department of Epidemiology, Brown University, Providence, Rhode Island, USA
| | - Sally Shumaker
- Wake Forest School of Medicine, Wake Forest University, Winston-Salem, North Carolina, USA
| | - JoAnn Manson
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Ying-Qing Feng
- Department of Cardiology, Guangdong Cardiovascular Institute, Hypertension Research Laboratory, Guangdong Provincial People's Hospital, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Academy of Medical Sciences, South China University of Technology School of Medicine, Guangzhou, China
| | - Simin Liu
- Centre for Global Cardiometabolic Health, Department of Epidemiology, Brown University, Providence, Rhode Island, USA
- Departments of Surgery and Medicine, Alpert School of Medicine, Brown University, Providence, Rhode Island, USA
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14
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Tzeng NS, Chung CH, Chang SY, Yeh CB, Lu RB, Chang HA, Kao YC, Chou YC, Yeh HW, Chien WC. Risk of psychiatric disorders in pulmonary embolism: a nationwide cohort study. J Investig Med 2019; 67:977-986. [PMID: 31266811 DOI: 10.1136/jim-2018-000910] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2019] [Indexed: 12/11/2022]
Abstract
This study aims to investigate the association between pulmonary embolism (PE) and the risk of psychiatric disorders. A total of 21,916 patients aged ≥20 years with PE between January 1, 2000, and December 31, 2015, were selected from the National Health Insurance Research Database of Taiwan, along with 65,748 (1:3) controls matched for sex and age. Cox regression model revealed the crude HR was 1.539 (95% CI 1.481 to 1.599; p<0.001), and after adjusting all the covariates, the adjusted HR was 1.704 (95% CI 1.435 to 1.991, p<0.001), for the risk of psychiatric disorders in the PE cohort. PE was associated with the overall psychiatric disorders, dementia, anxiety, depression, and sleep disorders, after the exclusion of the psychiatric diagnoses in the first year. PE was associated with the overall psychiatric disorders, dementia, anxiety, and depression, after the exclusion of the psychiatric diagnoses in the first 5 years. The patients with PE were associated with psychiatric disorders. This finding could serve as a reminder to the physicians to be more watchful and aware in the long-term follow-up of patients with PE for their care and potential mental health problems.
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Affiliation(s)
- Nian-Sheng Tzeng
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Student Counseling Center, National Defense Medical Center, Taipei, Taiwan
| | - Chi-Hsiang Chung
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,School of Public Health, National Defense Medical Center, Taipei, Taiwan.,Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan
| | - Shan-Yueh Chang
- Division of Chest and Critical Medicine, Department of Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Chin-Bin Yeh
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Ru-Band Lu
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Department of Psychiatry, College of Medicine & Hospital, National Chen-Gung University, Tainan, Taiwan
| | - Hsin-An Chang
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Student Counseling Center, National Defense Medical Center, Taipei, Taiwan
| | - Yu-Chen Kao
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Department of Psychiatry, Tri-Service General Hospital, Songshan Branch, Taipei, Taiwan
| | - Yu-Ching Chou
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Hui-Wen Yeh
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Institute of Bioinformatics and System Biology, National Chiao Tung University, Hsinchu, Taiwan
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,School of Public Health, National Defense Medical Center, Taipei, Taiwan.,Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
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15
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Tzeng NS, Chung CH, Chang HA, Chang CC, Lu RB, Yeh HW, Chiang WS, Kao YC, Chang SY, Chien WC. Obstructive Sleep Apnea in Children and Adolescents and the Risk of Major Adverse Cardiovascular Events: A Nationwide Cohort Study in Taiwan. J Clin Sleep Med 2019; 15:275-283. [PMID: 30736877 DOI: 10.5664/jcsm.7632] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Accepted: 11/15/2018] [Indexed: 12/18/2022]
Abstract
STUDY OBJECTIVES This study has investigated the risk of major adverse cardiovascular events (MACEs), including acute myocardial infarction, coronary artery disease, peripheral artery disease, and acute stroke, among children and adolescents (age younger than 20 years) with obstructive sleep apnea (OSA). METHODS In this study, the population-based National Health Insurance Research Database of Taiwan was used to identify patients in whom OSA had been first diagnosed between 2000 and 2015. Children and adolescents with OSA (n = 6,535) were included with 1:3 ratio by age, sex, and index year of control participants without OSA (n = 19,605). The Cox proportional regression model was used to evaluate the risk of MACEs in this cohort study. RESULTS After a 15-year follow-up, the incidence rate of MACEs was higher in the OSA cohort when compared with the non-OSA control cohort (15.97 and 8.20 per 100,000 person-years, respectively). After adjusting for covariates, the risk of MACEs among children and adolescents with OSA was still significantly higher (hazard ratio = 2.050; 95% confidence interval = 1.312-3.107; P = .010). No MACEs were found in the children and adolescents with OSA who received continuous airway positive pressure treatment or pharyngeal surgery. CONCLUSIONS This study found a significantly higher risk of MACEs in children and adolescents with OSA. These findings strongly suggest that clinicians should provide careful follow-up and medical treatment for children and adolescents with OSA.
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Affiliation(s)
- Nian-Sheng Tzeng
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, ROC.,Student Counseling Center, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Chi-Hsiang Chung
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.,School of Public Health, National Defense Medical Center, Taipei, Taiwan, ROC.,Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan, ROC
| | - Hsin-An Chang
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, ROC.,Student Counseling Center, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Chuan-Chia Chang
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Ru-Band Lu
- Department of Psychiatry, College of Medicine and Hospital, National Cheng-Kung University, Tainan, Taiwan, ROC.,Institute of Behavioral Medicine, College of Medicine, National Cheng-Kung University, Tainan, Taiwan, ROC
| | - Hui-Wen Yeh
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, ROC.,Institute of Bioinformatics and System Biology, National Chiao Tung University, Hsin-Chu, Taiwan, ROC.,Department of Nursing, Tri-Service General Hospital, and School of Nursing, National Defense Medical Center, Taipei, Taiwan, ROC.,Department of Nursing, Kang-Ning University (Taipei Campus), Taipei, Taiwan, ROC
| | - Wei-Shan Chiang
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Yu-Chen Kao
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, ROC.,Department of Psychiatry, Tri-Service General Hospital, Song-Shan Branch, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Shan-Yueh Chang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.,Graduate Institute of Medical Sciences, National Defense Medical Center, Taiwan, ROC
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.,School of Public Health, National Defense Medical Center, Taipei, Taiwan, ROC.,Graduate Institute of Life Sciences, National Defense Medical Center, Taiwan, ROC
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Tzeng NS, Chung CH, Lin FH, Chiang CP, Yeh CB, Huang SY, Lu RB, Chang HA, Kao YC, Yeh HW, Chiang WS, Chou YC, Tsao CH, Wu YF, Chien WC. Anti-herpetic Medications and Reduced Risk of Dementia in Patients with Herpes Simplex Virus Infections-a Nationwide, Population-Based Cohort Study in Taiwan. Neurotherapeutics 2018; 15:417-429. [PMID: 29488144 PMCID: PMC5935641 DOI: 10.1007/s13311-018-0611-x] [Citation(s) in RCA: 215] [Impact Index Per Article: 35.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
This retrospective cohort study is to investigate the association between herpes simplex virus (HSV) infections and dementia, and the effects of anti-herpetic medications on the risk involved, using Taiwan's National Health Insurance Research Database (NHIRD). We enrolled a total of 33,448 subjects, and identified 8362 with newly diagnosed HSV infections and 25,086 randomly selected sex- and age-matched controls without HSV infections in a ratio of 1:3, selected from January 1, to December 31, 2000. A multivariable Cox proportional hazards regression model was used to evaluate the risk of developing dementia in the HSV cohort. This analysis revealed an adjusted hazard ratio of 2.564 (95% CI: 2.351-2.795, P < 0.001) for the development of dementia in the HSV-infected cohort relative to the non-HSV cohort. Thus, patients with HSV infections may have a 2.56-fold increased risk of developing dementia. A risk reduction of dementia development in patients affected by HSV infections was found upon treatment with anti-herpetic medications (adjusted HR = 0.092 [95% CI 0.079-0.108], P < 0.001). The usage of anti-herpetic medications in the treatment of HSV infections was associated with a decreased risk of dementia. These findings could be a signal to clinicians caring for patients with HSV infections. Further research is, therefore, necessary to explore the underlying mechanism(s) of these associations.
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Affiliation(s)
- Nian-Sheng Tzeng
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Student Counseling Center, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Chi-Hsiang Chung
- Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan, Republic of China
- School of Public Health, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, 7115R, No.325, Section 2, Cheng-Kung Road, Neihu District, Taipei City, 11490, Taiwan, Republic of China
| | - Fu-Huang Lin
- School of Public Health, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Chien-Ping Chiang
- Department of Dermatology, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Chin-Bin Yeh
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - San-Yuan Huang
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Ru-Band Lu
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Clinical Psychology, Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China
- Department of Psychiatry, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China
- Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China
- Department of Psychiatry, National Cheng Kung University Hospital, Tainan, Taiwan, Republic of China
- Center for Neuropsychiatric Research, National Health Research Institute, Zhunan, Miaoli County, Taiwan, Republic of China
| | - Hsin-An Chang
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Student Counseling Center, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Yu-Chen Kao
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Department of Psychiatry, Tri-Service General Hospital, Song-Shan Branch, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Hui-Wen Yeh
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Wei-Shan Chiang
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Department and Institute of Mathematics, Tamkang University, New Taipei City, Taiwan, Republic of China
| | - Yu-Ching Chou
- School of Public Health, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Chang-Huei Tsao
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, 7115R, No.325, Section 2, Cheng-Kung Road, Neihu District, Taipei City, 11490, Taiwan, Republic of China
| | - Yung-Fu Wu
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, 7115R, No.325, Section 2, Cheng-Kung Road, Neihu District, Taipei City, 11490, Taiwan, Republic of China
| | - Wu-Chien Chien
- School of Public Health, National Defense Medical Center, Taipei, Taiwan, Republic of China.
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, 7115R, No.325, Section 2, Cheng-Kung Road, Neihu District, Taipei City, 11490, Taiwan, Republic of China.
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17
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Tzeng NS, Chang HA, Chung CH, Kao YC, Chang CC, Yeh HW, Chiang WS, Chou YC, Chang SY, Chien WC. Increased Risk of Psychiatric Disorders in Allergic Diseases: A Nationwide, Population-Based, Cohort Study. Front Psychiatry 2018; 9:133. [PMID: 29740354 PMCID: PMC5928780 DOI: 10.3389/fpsyt.2018.00133] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 03/28/2018] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND/OBJECTIVE Allergic diseases, such as bronchial asthma, allergic rhinitis, atopic dermatitis, and psychiatric disorders, are major health issues. There have been reports that allergic diseases were associated with depression or anxiety disorders. This study aimed to investigate the association between these allergic diseases and the risk of developing overall psychiatric disorders in patients from Taiwan. METHODS This cohort study used the database of the Taiwan National Health Insurance Program. A total of 186,588 enrolled patients, with 46,647 study subjects who had suffered from allergic diseases, and 139,941 controls matched for sex and age, from the Longitudinal Health Insurance Dataset of 2000-2015, were selected from a sub-dataset of the National Health Insurance Research Database. Fine and Gray's competing risk model analysis was used to explore the hazard ratio (HR), and 95% confidence interval, for the risk of allergic diseases being associated with the risk of developing psychiatric disorders during the 15 years of follow-up. RESULTS Of the study subjects, 5,038 (10.8%) developed psychiatric disorders when compared to 9,376 (6.7%) in the control group, with significant difference (p < 0.001). Fine and Gray's competing risk model analysis revealed that the adjusted HR was 1.659 (95% CI = 1.602-1.717, p < 0.001). In this study, we found that the groups of atopic dermatitis alone and the allergic rhinitis + atopic dermatitis were associated with a lower risk of psychiatric disorders, but all the other four groups, such as bronchial asthma alone, allergic rhinitis alone, bronchial asthma + allergic rhinitis, bronchial asthma + atopic dermatitis, and the combination of all these three allergic diseases, were associated with a higher risk of psychiatric disorders. CONCLUSION Allergic diseases are therefore associated with a 1.66-fold increased hazard of psychiatric disorders in Taiwan.
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Affiliation(s)
- Nian-Sheng Tzeng
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Student Counseling Center, National Defense Medical Center, Taipei, Taiwan
| | - Hsin-An Chang
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Student Counseling Center, National Defense Medical Center, Taipei, Taiwan
| | - Chi-Hsiang Chung
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan.,School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Yu-Chen Kao
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Department of Psychiatry, Tri-Service General Hospital, Song-Shan Branch, National Defense Medical Center, Taipei, Taiwan
| | - Chuan-Chia Chang
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Hui-Wen Yeh
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Institute of Bioinformatics and Systems Biology, National Chiao Tung University, Hsin-Chu, Taiwan.,Department of Nursing, Tri-Service General Hospital, School of Nursing, National Defense Medical Center, Taipei, Taiwan.,Department of Nursing, Kang-Ning University (Taipei Campus), Taipei, Taiwan
| | - Wei-Shan Chiang
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Yu-Ching Chou
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Shan-Yueh Chang
- Division of Chest and Critical Medicine, Department of Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan.,Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
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18
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Chu CW, Chien WC, Chung CH, Chao PC, Chang HA, Kao YC, Chou YC, Tzeng NS. Electroconvulsive Therapy and Risk of Dementia-A Nationwide Cohort Study in Taiwan. Front Psychiatry 2018; 9:397. [PMID: 30245639 PMCID: PMC6138057 DOI: 10.3389/fpsyt.2018.00397] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 08/07/2018] [Indexed: 12/12/2022] Open
Abstract
Background: Electroconvulsive therapy (ECT) is an effective treatment for schizophrenia, bipolar disorder, and major depressive disorder, and a temporary memory loss may occur after ECT. However, the association between ECT in patients with schizophrenia, bipolar disorder, and major depressive disorder, and the risk of dementia is yet to be examined. Objective: This study aimed to clarify as to whether ECT is associated with the risk of dementia after ECT in patients with schizophrenia, bipolar disorder, and major depressive disorder, using Taiwan's National Health Insurance Research Database (NHIRD). Methods: A total of 3,796 enrolled participants (schizophrenia, 46.68%; bipolar disorder, 11.77%; and major depressive disorder, 41.55%) with 994 patients who had received ECT and 2,982 controls matched for sex and age, between January 1, and December 31, 2000, were selected from the NHIRD. After adjusting for confounding factors, Fine and Gray's survival analysis was used to compare the risk of developing dementia during the 10 years of follow-up. Results: Of the study patients, 45 (4.53%) of them developed dementia when compared to 149 (5.0%) in the control group. Fine and Gray's survival analysis revealed that the study patients were not associated with an increased risk of dementia [hazard ratio (HR) = 0.612, 95% confidence interval (CI) = 0.438-1.854, P = 0.325]. After adjusting for sex, age, monthly income, urbanization level, geographic region, and comorbidities, the adjusted HR was 0.633 (95% CI = 0.448 - 1.895, P = 0.304). Conclusion: This study supports that ECT was not associated with the increased risk of dementia in patients with schizophrenia, bipolar disorder, and major depressive disorder, using the NHIRD.
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Affiliation(s)
- Ching-Wen Chu
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,School of Public Health, National Defense Medical Center, Taipei, Taiwan.,Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Chi-Hsiang Chung
- School of Public Health, National Defense Medical Center, Taipei, Taiwan.,Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan.,Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan
| | - Pei-Chun Chao
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Hsin-An Chang
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Student Counseling Center, National Defense Medical Center, Taipei, Taiwan
| | - Yu-Chen Kao
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Yu-Ching Chou
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Nian-Sheng Tzeng
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Student Counseling Center, National Defense Medical Center, Taipei, Taiwan
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