Higher Dementia Risk in People With Gastroesophageal Reflux Disease: A Real-World Evidence

Abstract

BackgroundWhether or not patients with gastroesophageal reflux disease (GERD) have a higher risk of developing subsequent dementia remains unknown, and no observational evidence from population-based data is available. This study was to determine whether patients with GERD have a higher future risk of developing dementia.MethodsFor the period 2000–2012, datasets from the Longitudinal Health Insurance Database (LHID, subset of National Health Insurance Research Database in Taiwan) were analyzed. Definition of GERD was based on ICD-9-CM codes 530.11 and 530.81 and prescriptions for PPIs. After matching gender, age, index year, and comorbidities, each GERD patient was matched with four control patients without GERD. Future risk of dementia was evaluated, and sensitivity analysis of subgroups was conducted to clarify the potential association.ResultsIn the present study, 13,570 patients were included in the GERD cohort and 54,280 patients were included in the control cohort. Patients with GERD showed higher risk developing dementia than control group, with an aHR of 1.34 (95% C.I., 1.07, 1.67). In GERD patients between above 70 years old, the risk of developing dementia was higher than that of the control groups (aHR = 1.34; 95% C.I., 1.01, 1.77).ConclusionPatients with GERD showed higher incidence of dementia, and elder patients had the highest risk of developing dementia. Clinicians should be concern of the association between GERD and dementia and should develop strategies to prevent dementia while managing patients with GERD.

Relationship of cognition and Alzheimer’s disease with gastrointestinal tract disorders: a large-scale genetic overlap and Mendelian randomisation analysis

“…In a reverse MR analysis, GERD demonstrated a signi cant causal association with decreased cognitive function. This nding suggests that genetic predisposition to GERD contributes to an increased risk of cognitive dysfunction which may partly explain the previous ndings of a positive association and genetic correlation between GERD and AD or dementia [7,11]. Although, in more conservative sensitivity testing, the signi cance of this nding waned and was no longer evident, together, the results of our follow-up analysis are more supportive of a putative causal effect of GERD on cognitive traits than otherwise.…”

“…Similar to the growing evidence linking AD with GIT traits [7][8][9][10][11][12][13][14], emerging ndings from conventional observational studies suggest a range of GIT disorders are associated with cognitive dysfunction [20][21][22][23]. For instance, a recent systematic review and meta-analysis, of cross-sectional studies, reported a signi cant risk of cognitive impairment (including de cits in attention, executive function, and working memory), in individuals with in ammatory bowel disease (IBD), compared to controls [20].…”

“…The bidirectional communication between the brain and the gut is well known, and the potential contribution of this phenomenon to the risk of dementia, Alzheimer's disease (AD), in particular, is a subject of increasing importance that continues to attract major attention in recent literature [1][2][3][4][5][6][7]. Several studies have reported a positive association between AD (or dementia, generally) and gut microbiota disruption, gastrointestinal tract (GIT) disorders or medications for gastritis, oesophageal re ux disease (GERD), and peptic ulcer disease (PUD) [7][8][9][10][11][12][13][14][15]. The likely roles of the immune (autoimmune) system, dysbiosis, enteric amyloid beta accumulation (Aβ), in ammatory processes, vagal nerve stimulation, and lipids metabolism, have been suggested [4,5,7,16,17].…”

Increased Risk of Hypothyroidism in People with Asthma: Evidence from a Real-World Population-Based Study

“…To address the issue, we only included those patients with more than two out-patient visits or one inpatient visit for hypothyroidism as our outcome event to validate the definition. The applied codes for diseases of interest and related comorbidities have also been utilized in previous real-world studies [ 15 , 38 , 39 ].…”

“…The Longitudinal Health Insurance Database (LHID), a sub-dataset from the Taiwanese National Health Insurance Research Database (NHIRD), has been utilized in the current study. The NHIRD is a database based on a compulsory National Health Insurance program in Taiwan, which has a greater than 90% coverage and has been widely utilized in previous studies [ 14 , 15 , 16 ]. Information regarding patients’ hospitalization, diagnostic records, urbanization and income data were available in the LHID.…”