eprintid: 10140443
rev_number: 12
eprint_status: archive
userid: 608
dir: disk0/10/14/04/43
datestamp: 2021-12-16 09:18:18
lastmod: 2021-12-16 09:18:18
status_changed: 2021-12-16 09:18:18
type: article
metadata_visibility: show
creators_name: Muzambi, R
creators_name: Bhaskaran, K
creators_name: Smeeth, L
creators_name: Brayne, C
creators_name: Chaturvedi, N
creators_name: Warren-Gash, C
title: Assessment of common infections and incident dementia using UK primary and secondary care data: a historical cohort study.
ispublished: pub
divisions: UCL
divisions: B02
divisions: D14
divisions: GA3
divisions: G17
divisions: D12
divisions: G20
note: © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licence.
abstract: Background: Common infections have been associated with dementia risk; however, evidence is scarce. We aimed to investigate the association between common infections and dementia in adults (≥65 years) in a UK population-based cohort study. Methods: We did a historical cohort study of individuals who were 65 years and older with no history of dementia or cognitive impairment using the Clinical Practice Research Datalink linked to Hospital Episode Statistics between Jan 1, 2004, and Dec 31, 2018. Multivariable Cox proportional hazard regression models were used to estimate the association between time-updated previous common infections (sepsis, pneumonia, other lower respiratory tract infections, urinary tract infections, and skin and soft tissue infections) and incident dementia diagnosis. We also tested for effect modification by diabetes since it is an independent risk factor for dementia and co-occurs with infection. Findings: Between Jan 1, 2004, and Dec 31, 2018, our study included 989 800 individuals (median age 68·6 years [IQR 65·0-77·0]; 537 602 [54·3%] women) of whom 402 204 (40·6%) were diagnosed with at least one infection and 56 802 (5·7%) had incident dementia during a median follow-up of 5·2 years (IQR 2·3-9·0). Dementia risk increased in those with any infection (adjusted hazard ratio [HR] 1·53 [95% CI 1·50-1·55]) compared with those without infection. HRs were highest for sepsis (HR 2·08 [1·89-2·29]) and pneumonia (HR 1·88 [1·77-1·99]) and for infections leading to hospital admission (1·99 [1·94-2·04]). HRs were also higher in individuals with diabetes compared with those without diabetes. Interpretation: Common infections, particularly those resulting in hospitalisation, were associated with an increased risk of dementia persisting over the long term. Whether reducing infections lowers the risk of subsequent dementia warrants evaluation. Funding: Alzheimer's Society, Wellcome Trust, and the Royal Society.
date: 2021-07-01
date_type: published
official_url: https://doi.org/10.1016/S2666-7568(21)00118-5
oa_status: green
full_text_type: pub
pmcid: PMC8245326
language: eng
primo: open
primo_central: open_green
verified: verified_manual
elements_id: 1875898
doi: 10.1016/S2666-7568(21)00118-5
pii: S2666-7568(21)00118-5
lyricists_name: Chaturvedi, Nishi
lyricists_name: Warren-Gash, Charlotte
lyricists_id: NCHAT95
lyricists_id: CWARR05
actors_name: Barczynska, Patrycja
actors_id: PBARC91
actors_role: owner
full_text_status: public
publication: Lancet Healthy Longev
volume: 2
number: 7
pagerange: e426-e435
event_location: England
citation:        Muzambi, R;    Bhaskaran, K;    Smeeth, L;    Brayne, C;    Chaturvedi, N;    Warren-Gash, C;      (2021)    Assessment of common infections and incident dementia using UK primary and secondary care data: a historical cohort study.                   Lancet Healthy Longev , 2  (7)   e426-e435.    10.1016/S2666-7568(21)00118-5 <https://doi.org/10.1016/S2666-7568%2821%2900118-5>.       Green open access   
 
document_url: https://discovery.ucl.ac.uk/id/eprint/10140443/1/Chaturved_PIIS2666756821001185.pdf