Association of cardiovascular disease and traditional cardiovascular risk factors with the incidence of dementia among patients with rheumatoid arthritis

Sattui, Sebastian E.; Rajan, Mangala; Lieber, Sarah B.; Lui, Geyanne; Sterling, Madeline R; Curtis, Jeffrey R.; Mandl, Lisa A.; Navarro‐Millán, Iris

doi:10.1016/j.semarthrit.2020.09.022

Cited by 15 publications

(5 citation statements)

References 56 publications

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“…Ungprasert P et al found an approximately 40% increased risk of dementia in patients with RA compared to general population which can be attributed to this adverse CVD profile superimposed on systemic inflammation (8). Indeed, among elderly RA patients, the risk of dementia increases with increasing CVD risk (presence of CVD risk factors and any CVD events) (36). We extended these findings by evaluating associations with individual CVD risk factors and CVD events.…”

Section: Discussionmentioning

confidence: 70%

Risk Factors for Dementia in Patients With Incident Rheumatoid Arthritis: A Population-Based Cohort Study

et al. 2022

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Objective Growing evidence suggests that patients with rheumatoid arthritis (RA) have increased risk for dementia. We assessed risk factors for incident dementia in an inception cohort of RA. Methods This retrospective population-based cohort study included residents of eight counties in Minnesota who were ≥50 years when they met 1987 ACR criteria for incident RA between 1980-2014 and were followed until death/migration or 12/31/2019. Patients with dementia before RA incidence were excluded. Incident dementia was defined as two relevant ICD-9/ICD-10 codes at least 30 days apart. Data on socio-demographics, disease characteristics, cardiovascular/cerebrovascular disease (CVD) risk factors and comorbidities were abstracted from medical records. Results The study included 886 patients with RA (mean age=65 years, 65% females). During the follow-up period (median=8.5 years), 103 patients developed dementia. After adjusting for age, sex and calendar year of RA incidence, older age at RA incidence (Hazard Ratio (HR):1.14 per 1 year increase, confidence interval (CI):1.12-1.17), rheumatoid nodules (HR:1.76,CI:1.05- 2.95), hypertension (HR:1.84,CI:1.19-2.85), presence of large joint swelling (HR:2.03,CI:1.14-3.60), any CVD (HR:2.25,CI:1.38-3.66), particularly ischemic stroke (HR:3.16,CI:1.84-5.43) and heart failure (HR:1.82,CI:1.10-3.00), anxiety (HR:1.86,CI:1.16-2.97), and depression (HR:2.63,CI:1.76-3.93) were associated with increased risk of dementia. After adjusting for CVD risk factors and any CVD, all covariates listed above were still significantly associated with risk of dementia. Conclusion Apart from age, hypertension, depression, and anxiety, which are universally recognized risk factors for dementia, clinically active RA and presence of CVD were associated with an elevated risk of dementia incidence among RA patients.

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Section: Discussionmentioning

confidence: 70%

Risk Factors for Dementia in Patients With Incident Rheumatoid Arthritis: A Population-Based Cohort Study

et al. 2022

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“…However, glucosamine use was not significantly associated with incident Alzheimer’s disease and frontotemporal dementia. Previous studies have found that glucosamine supplementation was associated with a reduced risk of CVD [ 5 ] and type 2 diabetes [ 13 ], both of which are associated with an increased risk of dementia, particularly vascular dementia [ 33 , 34 ]. In addition, a previous randomized trial, including 38 subjects diagnosed with knee osteoarthritis, showed that glucosamine sulfate supplements could modulate the metabolic and immune activity of the gastrointestinal microbiota [ 35 ], thereby affecting the risk of neurodegenerative diseases [ 36 ].…”

Section: Discussionmentioning

confidence: 99%

Habitual glucosamine use, APOE genotypes, and risk of incident cause-specific dementia in the older population

Zhou,

Zhang,

Yang

et al. 2023

Alz Res Therapy

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Background The relationship of glucosamine use with incident dementia in the older population remains uncertain. We aimed to evaluate the longitudinal association between habitual glucosamine supplement and the risk of cause-specific dementia and examine the possible effect modifiers on this association. Methods The study included 214,945 participants over the age of 60 who had available information on glucosamine use and did not have dementia at baseline in the UK Biobank. The APOE genotypes were determined by a combination variant of rs429358 and rs7412. The primary outcome was incident vascular dementia, incident Alzheimer’s disease, and incident frontotemporal dementia, respectively. Results Over a median follow-up duration of 12 years, 1039, 1774, and 122 participants developed vascular dementia, Alzheimer’s disease, and frontotemporal dementia, respectively. Overall, habitual glucosamine use was significantly associated with a lower risk of incident vascular dementia (adjusted HR, 0.82; 95%CI, 0.70–0.96), but not significantly associated with incident Alzheimer’s disease (adjusted HR, 1.02; 95%CI, 0.92–1.14) and incident frontotemporal dementia (adjusted HR, 0.95; 95%CI, 0.63–1.43). Moreover, the inverse association between habitual glucosamine use and incident vascular dementia was more pronounced in participants with concomitant supplement of calcium (P-interaction = 0.011), and those without concomitant supplement of zinc (P-interaction = 0.018). However, APOE ε4 dosage and baseline cognitive function did not significantly modify the relationships of glucosamine use with incident vascular dementia or Alzheimer’s disease (All P-interactions > 0.05). Conclusions Regardless of APOE genotypes and baseline cognitive function, habitual glucosamine use was significantly inversely associated with incident vascular dementia in the older population.

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“…Some crosssectional studies were not able to prove an association between rheumatoid arthritis (RA) and dementia (42,43). However, Sattui et al (44) described an increased risk of dementia in RA patients with a cardiovascular risk factor or cardiovascular disease. Furthermore, Gwinnutt et al (45) reported cognitive decline in RA patients compared with age-matched healthy controls by a cognitive assessment test.…”

Section: Discussionmentioning

confidence: 99%

Impact of Clinical Association Between Gout and Dementia: A Nationwide Population‐Based Cohort Study in Korea

Kim

Yim

Choi

et al. 2022

Arthritis Care & Research

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Objective. Hyperuricemia might have neuroprotective or neurodegenerative effects on dementia via oxidative stress or inflammatory response regulation. Few studies have explored the association of hyperuricemia or gout with dementia. This retrospective cohort study aimed to investigate the association between gout and dementia in Korea.Methods. Altogether, 5,052 gout patients and 25,260 age-and sex-matched controls were selected from the National Health Insurance Service (NHIS)-National Sample Cohort database. The incidence and risk of dementia were evaluated by reviewing the NHIS record. We also performed a subgroup analysis according to age group (age <65 or ≥65 years) using the standard age of 65 years for elderly and nonelderly groups and sex.Results. During follow-up, 81 and 558 participants in the gout and control cohorts developed dementia, respectively. The mean follow-up duration was 4.38 years in gout patients and 4.94 years in controls. Gout patients had a hazard ratio (HR) of 0.79 for overall dementia (95% confidence interval [95% CI] 0.62-1.00) and significantly lower Alzheimer's disease risk (HR 0.73 [95% CI 0.54-0.98]) after adjusting for age, sex, household income, and comorbidities. In subgroup analysis stratified by age and sex, the inverse association between gout and the risk of overall dementia (HR 0.71 [95% CI 0.52-0.97]) and Alzheimer's disease (HR 0.67 [95% CI 0.46-0.97]) were observed in the elderly male group. On the other hand, age-and sex-adjusted analysis showed that the HR for vascular dementia of gout patients was 2.31 (95% CI 1.02-5.25) in the nonelderly male group.Conclusion. Gout decreased the risk of incident Alzheimer's disease-type dementia, especially in elderly patients. The association between gout and dementia risk may differ according to age and disease duration.

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Association of cardiovascular disease and traditional cardiovascular risk factors with the incidence of dementia among patients with rheumatoid arthritis

Cited by 15 publications

References 56 publications

Risk Factors for Dementia in Patients With Incident Rheumatoid Arthritis: A Population-Based Cohort Study

Risk Factors for Dementia in Patients With Incident Rheumatoid Arthritis: A Population-Based Cohort Study

Habitual glucosamine use, APOE genotypes, and risk of incident cause-specific dementia in the older population

Impact of Clinical Association Between Gout and Dementia: A Nationwide Population‐Based Cohort Study in Korea

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