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Association between dementia risk and ulcerative colitis, with and without colectomy: a Swedish population-based register study

Association between dementia risk and ulcerative colitis, with and without colectomy: a Swedish population-based register study
Association between dementia risk and ulcerative colitis, with and without colectomy: a Swedish population-based register study
Objective: this study aims to investigate the association of ulcerative colitis (UC) with all-cause dementia and assess differences in those with and without a total colectomy.

Design, setting and participants: this Swedish prospective register-based study comprised 4.8 million individuals aged at least 59 years between 1964 and 2018 with the linkage of several Swedish national registers.

Primary and secondary outcome measures: individuals with dementia were defined according to International Classification of Diseases diagnostic codes and Anatomical Therapeutic Classification codes for medication prescriptions. Fitting Cox hazards models, the risk of developing all-cause dementia in individuals with and without UC was estimated. Further, we compared the risk of all-cause dementia among those with and without a colectomy.

Results: among 4 821 488 individuals (52.6% females) followed for 84.1 million person-years between 1964 and 2018, the incidence rate of all-cause dementia was 63.90 (63.73–64.07) events per 10 000 person-years in individuals without UC, 94.80 (92.04–97.64) among those with UC, 95.01 (92.25–97.86) in those with UC but without colectomy and 63.42 (40.92–98.31) in those with UC and a colectomy. Adjusted Cox models showed an increased all-cause dementia risk in individuals with UC (HR 1.07, 95% CI 1.04 to 1.10). We found no differences between unexposed individuals and those with UC and a colectomy (HR 0.89, 95% CI 0.57 to 1.38).

Conclusion: the findings are consistent with previous evidence suggesting a slightly increased dementia risk among individuals with UC. This study provided no evidence of further risk increase of dementia among those who had a colectomy.
epidemiology, gastroenterology, inflammatory bowel disease
2044-6055
Garcia-Argibay, Miguel
e5a6941e-4dcc-401a-9de4-09557c8856ef
Hiyoshi, Ayako
4755811b-d7c7-43a0-b187-bc8e52dafe01
Montgomery, Scott
38108870-54a5-4c25-8028-31bb04febd91
Garcia-Argibay, Miguel
e5a6941e-4dcc-401a-9de4-09557c8856ef
Hiyoshi, Ayako
4755811b-d7c7-43a0-b187-bc8e52dafe01
Montgomery, Scott
38108870-54a5-4c25-8028-31bb04febd91

Garcia-Argibay, Miguel, Hiyoshi, Ayako and Montgomery, Scott (2023) Association between dementia risk and ulcerative colitis, with and without colectomy: a Swedish population-based register study. BMJ Open, 13 (12), [e074110]. (doi:10.1136/bmjopen-2023-074110).

Record type: Article

Abstract

Objective: this study aims to investigate the association of ulcerative colitis (UC) with all-cause dementia and assess differences in those with and without a total colectomy.

Design, setting and participants: this Swedish prospective register-based study comprised 4.8 million individuals aged at least 59 years between 1964 and 2018 with the linkage of several Swedish national registers.

Primary and secondary outcome measures: individuals with dementia were defined according to International Classification of Diseases diagnostic codes and Anatomical Therapeutic Classification codes for medication prescriptions. Fitting Cox hazards models, the risk of developing all-cause dementia in individuals with and without UC was estimated. Further, we compared the risk of all-cause dementia among those with and without a colectomy.

Results: among 4 821 488 individuals (52.6% females) followed for 84.1 million person-years between 1964 and 2018, the incidence rate of all-cause dementia was 63.90 (63.73–64.07) events per 10 000 person-years in individuals without UC, 94.80 (92.04–97.64) among those with UC, 95.01 (92.25–97.86) in those with UC but without colectomy and 63.42 (40.92–98.31) in those with UC and a colectomy. Adjusted Cox models showed an increased all-cause dementia risk in individuals with UC (HR 1.07, 95% CI 1.04 to 1.10). We found no differences between unexposed individuals and those with UC and a colectomy (HR 0.89, 95% CI 0.57 to 1.38).

Conclusion: the findings are consistent with previous evidence suggesting a slightly increased dementia risk among individuals with UC. This study provided no evidence of further risk increase of dementia among those who had a colectomy.

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Accepted/In Press date: 6 December 2023
e-pub ahead of print date: 22 December 2023
Published date: 22 December 2023
Additional Information: © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.
Keywords: epidemiology, gastroenterology, inflammatory bowel disease

Identifiers

Local EPrints ID: 488779
URI: http://eprints.soton.ac.uk/id/eprint/488779
ISSN: 2044-6055
PURE UUID: a659842a-0007-4fd3-80bb-b7b2e648a0db
ORCID for Miguel Garcia-Argibay: ORCID iD orcid.org/0000-0002-4811-2330

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Date deposited: 05 Apr 2024 16:38
Last modified: 06 Jun 2024 02:21

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Author: Miguel Garcia-Argibay ORCID iD
Author: Ayako Hiyoshi
Author: Scott Montgomery

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