Incidence of Newly-Diagnosed Dementia After COVID-19 Infection versus Acute Upper Respiratory Infection: A Retrospective Cohort Study

BACKGROUND

There is emerging evidence that coronavirus disease 2019 (COVID-19) is giving rise to seemingly unrelated clinical conditions long after the infection has resolved.

OBJECTIVE

The aim of this study is to examine whether COVID-19 is associated with an increased risk of dementia including Alzheimer's disease.

METHODS

This retrospective cohort study is based on longitudinal data from the IQVIATM Disease Analyzer database and included patients aged≥65 with an initial diagnosis of COVID-19 or acute upper respiratory infection (AURI) from 1,293 general practitioner practices between January 2020 and November 2021. AURI patients were matched 1 : 1 with COVID-19 patients using propensity scores based on sex, age, index quarter, health insurance type, the number of doctor visits, and comorbidities associated with dementia risk. Incidence rates of newly-diagnosed dementia were calculated using the person-years method. Poisson regression models were used to compute the incidence rate ratios (IRR).

RESULTS

The present study included 8,129 matched pairs (mean age 75.1 years, 58.9% females). After 12 months of follow-up, 1.84% of the COVID-19 patients and 1.78% of the AURI patients had been diagnosed with dementia. The Poisson regression model resulted in an IRR of 1.05 (95% CI: 0.85-1.29).

CONCLUSION

This study did not find any association between COVID-19 infection and one-year dementia incidence after controlling for all common risk factors for dementia. Because dementia is a progressive disease, which can be difficult to diagnose, a longer follow-up period might offer a better insight into a possible association between COVID-19 infection and an increased incidence of dementia cases in the future.

Association between Inflammatory Bowel Disease and Subsequent Development of Restless Legs Syndrome and Parkinson’s Disease: A Retrospective Cohort Study of 35,988 Primary Care Patients in Germany

Background: In addition to the gastrointestinal symptoms, inflammatory bowel disease (IBD), which includes Crohn’s disease (CD) and ulcerative colitis (UC), is associated with extraintestinal manifestations, including neurological disorders, which are gaining increasing attention due to a recently increased focus on the gut–brain axis. Here we aim to evaluate the association between IBD and restless legs syndrome (RLS) as well as Parkinson’s disease (PD) in a cohort of primary care patients in Germany. Methods: The study included 17,994 individuals with a diagnosis of IBD (7544 with CD and 10,450 with UC) and 17,994 propensity-score-matched individuals without IBD from the Disease Analyzer database (IQVIA). An initial diagnosis of RLS or PD was assessed as a function of IBD. Associations between CD and UC with RLS and PD were analyzed using Cox regression models. Results: During the 10-year observation period, 3.6% of CD patients vs. 1.9% of matched non-IBD pairs (p < 0.001) and 3.2% of UC patients vs. 2.7% of matched pairs (p < 0.001) were diagnosed with RLS. The results were confirmed by Cox regression analysis, which showed a significant association between UC (HR: 1.26; 95% CI: 1.02–1.55) and CD (HR: 1.60; 95% CI: 1.23–2.09) and subsequent RLS. The incidence of PD in IBD patients was not significantly increased. However, we observed a non-significant trend towards a higher incidence of PD in male patients with CD but not UC (HR: 1.55; 95%CI: 0.98–2.45, p = 0.064). Conclusions: The present analysis suggests a significant association between IBD and the subsequent development of RLS. These findings should stimulate further pathophysiological research and may eventually lead to specific screening measures in patients with IBD.

An analysis of the readability and cultural sensitivity of information on the National Cancer Institute's Web site: CancerNet

PURPOSE/OBJECTIVES

To ascertain the level of reading skills required by lay people who access patient-related cancer information through CancerNet, the Web site of the National Cancer Institute (NCI), and to assess the cultural sensitivity of the information targeted to certain ethnic groups.

DESIGN

Descriptive study, repeated measures.

SETTING

NCI's CancerNet Web site (http://cancernet.nci.nih.gov).

SAMPLE

A convenience sample of 49 documents from the CancerNet Web site was analyzed.

METHODS

The readability of each document was analyzed using the Flesch-Kincaid readability formula. Using Bloch's Ethnic/Cultural Assessment Tool as a guide, a content analysis of the ethnic-related documents was performed to determine the cultural sensitivity of the information.

MAIN RESEARCH VARIABLES

Readability and cultural sensitivity of the written cancer information.

FINDINGS

The overall mean reading level was 12th grade. Little variation existed in the cultural content of the information even though several ethnic groups were targeted.

CONCLUSION

Information on CancerNet needs to be modified to meet the information needs of people with low reading skills and to make the information more culturally sensitive for various ethnic groups.

IMPLICATIONS FOR NURSING PRACTICE

Finding successful methods for educating patients and families is a primary responsibility of oncology nurses. Information can play a vital role in helping patients to engage in self-care behavior. Therefore, nurses must be knowledgeable about the readability, usefulness, and cultural-sensitivity of information on cancer Web sites so that they can guide patients to appropriate Internet resources.