دورية أكاديمية
أعرض في EDS

Incidence of Dementia Following Hospitalization With Infection Among Adults in the Atherosclerosis Risk in Communities (ARIC) Study Cohort.

التفاصيل البيبلوغرافية
العنوان: Incidence of Dementia Following Hospitalization With Infection Among Adults in the Atherosclerosis Risk in Communities (ARIC) Study Cohort.
المؤلفون: Bohn B; Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis., Lutsey PL; Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis., Misialek JR; Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis., Walker KA; Laboratory of Behavioral Neuroscience, National Institute on Aging, National Institutes of Health, Baltimore, Maryland., Brown CH; Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland., Hughes TM; Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina., Ishigami J; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland., Matsushita K; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland., Demmer RT; Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis.; Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York.
المصدر: JAMA network open [JAMA Netw Open] 2023 Jan 03; Vol. 6 (1), pp. e2250126. Date of Electronic Publication: 2023 Jan 03.
نوع المنشور: Journal Article; Research Support, N.I.H., Intramural; Research Support, N.I.H., Extramural
اللغة: English
بيانات الدورية: Publisher: American Medical Association Country of Publication: United States NLM ID: 101729235 Publication Model: Electronic Cited Medium: Internet ISSN: 2574-3805 (Electronic) Linking ISSN: 25743805 NLM ISO Abbreviation: JAMA Netw Open Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Chicago, IL : American Medical Association, [2018]-
مواضيع طبية MeSH: Atherosclerosis*/epidemiology , Hospitalization*, Adult ; Female ; Humans ; Middle Aged ; Incidence ; Prospective Studies ; Male
مستخلص: Importance: Factors associated with the risk of dementia remain to be fully understood. Systemic infections are hypothesized to be such factors and may be targets for prevention and screening.
Objective: To investigate the association between hospitalization with infection and incident dementia.
Design, Setting, and Participants: Data from the community-based Atherosclerosis Risk in Communities (ARIC) study, a prospective cohort study, were used. Enrollment occurred at 4 research centers in the US, initiated in 1987 to 1989. The present study includes data up to 2019, for 32 years of follow-up. Data analysis was performed from April 2021 to June 2022.
Exposures: Hospitalizations with infections were identified via medical record review for selected International Classification of Diseases, Ninth Revision (ICD-9) and International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) codes, from baseline until administrative censoring or dementia diagnosis. Participants were considered unexposed until first hospitalization with infection and exposed thereafter. Selected infection subtypes were also considered.
Main Outcomes and Measures: Incident dementia and time-to-event data were identified through surveillance of ICD-9 and ICD-10 hospitalization and death certificate codes, in-person assessments, and telephone interviews. A sensitivity analysis was conducted excluding cases occurring within 3 years or beyond 20 years from exposure. Data were collected before study hypothesis formulation.
Results: Of the 15 792 ARIC study participants, an analytical cohort of 15 688 participants who were dementia free at baseline and of Black or White race were selected (8658 female [55.2%]; 4210 Black [26.8%]; mean [SD] baseline age, 54.7 [5.8] years). Hospitalization with infection occurred among 5999 participants (38.2%). Dementia was ascertained in 2975 participants (19.0%), at a median (IQR) of 25.1 (22.2-29.1) years after baseline. Dementia rates were 23.6 events per 1000 person-years (95% CI, 22.3-25.0 events per 1000 person-years) among the exposed and 5.7 events per 1000 person-years (95% CI, 5.4-6.0 events per 1000 person-years) among the unexposed. Patients hospitalized with infection were 2.02 (95% CI, 1.88-2.18; P < .001) and 1.70 (95% CI, 1.55-1.86; P < .001) times more likely to experience incident dementia according to unadjusted and fully adjusted Cox proportional hazards models compared with individuals who were unexposed. When excluding individuals who developed dementia less than 3 years or more than 20 years from baseline or the infection event, the adjusted hazard ratio was 5.77 (95% CI, 4.92-6.76; P < .001). Rates of dementia were significantly higher among those hospitalized with respiratory, urinary tract, skin, blood and circulatory system, or hospital acquired infections. Multiplicative and additive interactions were observed by age and APOE-ε genotype.
Conclusions and Relevance: Higher rates of dementia were observed among participants who experienced hospitalization with infection. These findings support the hypothesis that infections are factors associated with higher risk of dementias.
References: Eur J Clin Microbiol Infect Dis. 2007 May;26(5):349-52. (PMID: 17431694)
Am J Respir Crit Care Med. 2013 Sep 1;188(5):586-92. (PMID: 23848267)
Alzheimers Dement (Amst). 2016 Sep 10;4:109-117. (PMID: 27752534)
Stroke. 2018 Feb;49(2):355-362. (PMID: 29335336)
ACS Chem Neurosci. 2019 Aug 21;10(8):3340-3342. (PMID: 31241312)
Alzheimers Dement. 2019 Apr;15(4):534-542. (PMID: 30777379)
J Am Geriatr Soc. 2018 Oct;66(10):1919-1926. (PMID: 30251380)
J Am Heart Assoc. 2018 Nov 20;7(22):e009683. (PMID: 30571501)
Nat Rev Immunol. 2018 Dec;18(12):759-772. (PMID: 30140051)
Prog Neuropsychopharmacol Biol Psychiatry. 2022 Dec 20;119:110610. (PMID: 35908596)
Neurology. 2020 Sep 22;95(12):e1660-e1671. (PMID: 32727837)
Crit Care Med. 2014 May;42(5):1037-46. (PMID: 24368344)
Am J Kidney Dis. 2017 Jun;69(6):752-761. (PMID: 27884474)
Nature. 2022 Apr;604(7907):697-707. (PMID: 35255491)
Diabetologia. 2004 Sep;47(9):1550-6. (PMID: 15338129)
Lancet Neurol. 2011 Sep;10(9):819-28. (PMID: 21775213)
J Neuroinflammation. 2018 Jan 30;15(1):28. (PMID: 29382344)
Diabetes Care. 2008 Jul;31(7):1373-9. (PMID: 18390797)
Clin Chem. 1972 Jun;18(6):499-502. (PMID: 4337382)
Neurology. 2015 Apr 7;84(14):1443-53. (PMID: 25762715)
J Am Coll Cardiol. 2021 Jun 15;77(23):2939-2959. (PMID: 34112321)
Alzheimer Dis Assoc Disord. 2005 Apr-Jun;19(2):91-4. (PMID: 15942327)
J Alzheimers Dis. 2020;76(4):1609-1626. (PMID: 32651320)
Lancet Infect Dis. 2021 Nov;21(11):1557-1567. (PMID: 34166620)
Alzheimers Dement (Amst). 2016;2:1-11. (PMID: 26949733)
Nat Rev Neurol. 2010 Dec;6(12):681-94. (PMID: 21060340)
معلومات مُعتمدة: K01 DK125616 United States DK NIDDK NIH HHS; K76 AG057020 United States AG NIA NIH HHS; K24 HL159246 United States HL NHLBI NIH HHS; P30 AG072947 United States AG NIA NIH HHS; RF1 AG072387 United States AG NIA NIH HHS
تواريخ الأحداث: Date Created: 20230109 Date Completed: 20230112 Latest Revision: 20240412
رمز التحديث: 20240412
مُعرف محوري في PubMed: PMC9857407
DOI: 10.1001/jamanetworkopen.2022.50126
PMID: 36622673
قاعدة البيانات: MEDLINE
الوصف
تدمد:2574-3805
DOI:10.1001/jamanetworkopen.2022.50126