Investigating the association between cancer and dementia risk: a longitudinal cohort study

Abstract

Background Previous studies found that cancer survivors had a reduced risk of dementia compared with the general population. However, these findings were uncertain because of survivor bias and a lack of stratification by cancer types. This current cohort study used data from the UK Biobank to explore these associations. Methods Multivariable Cox regression analyses were used to examine the association of cancer status and the risk of dementia with its subtypes after adjusting for age and sex. Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated as a measure of relative risk by comparing observed dementia incidence among cancer patients. Results We included 263,151 participants in the observational analysis. During a median follow-up of 9.18 years, dementia was diagnosed in 472 individuals with cancer and 3685 individuals without cancer, respectively. Cancer patients had lower risks of dementia (hazard ratio: 0.89, confidence interval: 0.81–0.98) and its subtypes (Alzheimer’s disease [AD]: 0.85 [0.74–0.98]; vascular dementia [VD]: 0.81 [0.66–0.99]) in the Cox regression adjusted for age and sex. Individuals with cancers in the male genital system had substantially reduced risks of dementia (0.66 [0.46–0.93]) and AD (0.53 [0.29–0.97]) than those with cancers in other systems. Moreover, non-melanoma skin cancer and prostate cancer were associated with a reduced risk of dementia (0.79 [0.62–0.99]; 0.69 [0.49–0.97]), but not with AD or VD (P>0.05). Conclusions The current study supported a negative association between cancer and dementia risk, and encourages further exploration of the mechanistic basis of this inverse relationship to improve understanding.

Mid‐life adherence to the Dietary Approaches to Stop Hypertension (DASH) diet and late‐life subjective cognitive complaints in women

“…The results of this study support a beneficial role of long‐term adherence to DASH dietary pattern in subjective cognitive function among women 23 . Studies are needed to confirm these findings and explore potential effect modifiers, such as demographic and lifestyle factors and comorbidities, such as cancer and depression, given their associations with cognitive function, AD, or dementia and/or dietary patterns 7,8,24–29 …”

“…We first adjusted for age at the time of SCCs and other baseline potential confounders, including, menopausal status, race, education attainment, smoking status, BMI, and total caloric intake (Model 1). Additional adjustment for history of cancer and use of depression medication was conducted (Model 2), as these comorbidities may influence cognition and be associated with diet 7,24,25,27,29 . We hypothesized that the comorbidity conditions are potential confounders and/or effect modifiers.…”

“…33,[35][36][37] The DASH score has been validated [38][39][40] and considered in many studies of cancer and cardiovascular disease. 29,41 We then used the DASH score distribution to classify women into quartiles, resulting in the following groupings: Q1 (10-20), Q2 (21)(22)(23)(24), Q3 (25)(26)(27), Q4 (28)(29)(30)(31)(32)(33)(34)(35)(36)(37). This quartile classification was determined so that we have sufficient power (0.80; estimated using Quanto) 42 to estimate approximately a minimal odds ratio (OR) of 0.80 in a comparison between any two quartiles.…”

“…23 Studies are needed to confirm these findings and explore potential effect modifiers, such as demographic and lifestyle factors and comorbidities, such as cancer and depression, given their associations with cognitive function, AD, or dementia and/or dietary patterns. 7,8,[24][25][26][27][28][29] The objective of the present study was to assess the association between the DASH score measured in mid-life, and SCCs reported later in life in the New York University Women's Health Study (NYUWHS), a prospective cohort study with > 30 years of follow-up.…”

Sting and p53 DNA repair pathways are compromised in Alzheimer’s disease

“…Unfolding of p53 is unrelated to its oligomerization state 131 and can be produced when p53 is not bound to its cognate DNA 132 or when p53 is artificially concentrated in vitro . The involvement of p53 also provides a possible explanation for the long-hypothesized inverse connections between AD and cancer, recently replicated in large longitudinal studies 133 – 135 .…”