Association between non-cystic fibrosis bronchiectasis and the risk of incident dementia: A nationwide cohort study

Author:

Kim Sang Hyuk12ORCID,Han Kyungdo3,Park Jongkyu4,Park Dong Won5,Moon Ji-Yong5ORCID,Sim Yun Su1ORCID,Kim Tae-Hyung5,Kim Sang-Heon5,Sohn Jang Won5,Yoon Ho Joo5,Lee Hyun5,Choi Hayoung1ORCID

Affiliation:

1. Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea

2. Department of Internal Medicine, Dongguk University Gyeongju Hospital, Dongguk University College of Medicine, Gyeongju, Korea

3. Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea

4. Department of Neurology, Soonchunhyang University College of Medicine, Soonchunhyang University, Cheonan, Korea

5. Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea

Abstract

Background Chronic lung diseases, such as chronic obstructive pulmonary disease or asthma, are associated with an increased risk of dementia. However, few data are available regarding the risk of dementia in individuals with bronchiectasis. Objectives To explore the association between bronchiectasis and the risk of incident dementia using a longitudinal population-based cohort. Methods A total of 4,068,560 adults older than 50 years without previous dementia were enrolled from the Korean National Health Insurance Service database in 2009. They were followed up until the date of the diagnosis of dementia or December 31, 2020. The study exposure was the diagnosis of bronchiectasis, and the primary outcome was incident dementia comprising Alzheimer’s disease and vascular dementia. Results During the median follow-up duration of 9.3 years, the incidence of all-cause dementia was 1.6-fold higher in individuals with bronchiectasis than in those without bronchiectasis (15.0 vs. 9.3/1000 person-years, p < .001). In the multivariable Cox regression analysis, the risk of all dementia was significantly higher in individuals with bronchiectasis than in those without bronchiectasis (adjusted hazard ratio [aHR] 1.09, 95% confidence interval [CI] 1.04–1.14). In a subgroup analysis by dementia type, individuals with bronchiectasis had an increased risk of Alzheimer’s disease compared to those without bronchiectasis (aHR 1.07, 95% CI 1.01–1.12); the risk of vascular dementia did not significantly differ between the two groups (aHR 1.05, 95% CI 0.90–1.21). Conclusion Bronchiectasis was associated with an increased risk of dementia, especially Alzheimer’s disease.

Funder

Ministry of Education

Publisher

SAGE Publications

Subject

Pulmonary and Respiratory Medicine

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