Association between dementia and systemic rheumatic disease: A nationwide population-based study

Area of Science:

• Rheumatology
• Neurology
• Epidemiology

Background:

• Systemic rheumatic diseases involve autoimmunity and inflammation, potentially affecting multiple organs.
• The link between autoimmune diseases and dementia risk remains under-researched.
• This study investigates the association between systemic rheumatic disease and dementia using a large population database.

Purpose of the Study:

• To evaluate the relationship between systemic rheumatic disease and dementia.
• To identify specific rheumatic diseases associated with increased dementia risk.
• To inform early detection and prevention strategies for at-risk populations.

Main Methods:

• A nationwide population-based study utilized the Korean National Health Insurance Service (NHIS) claims database (2002-2013).
• Dementia was defined by acetylcholinesterase inhibitors prescription and ICD-10 codes for Alzheimer's disease (AD) or vascular dementia (VaD).
• Rheumatic diseases included rheumatoid arthritis (RA), Sjögren's syndrome (SS), systemic lupus erythematosus (SLE), and Behcet's disease (BD), diagnosed at least 6 months prior to dementia diagnosis.

Main Results:

• Systemic lupus erythematosus (SLE) was significantly more prevalent in dementia patients (0.2%) compared to controls (0.1%).
• SLE history was associated with a 2.48-fold increased odds of dementia.
• SLE independently increased the risk for both Alzheimer's disease (OR, 2.29) and vascular dementia (OR, 4.54).

Conclusions:

• Systemic lupus erythematosus (SLE) is independently associated with a higher risk of dementia, including AD and VaD.
• SLE patients under 65 years old represent a high-risk group for early vascular dementia.
• Targeted screening and proactive prevention are crucial for SLE patients to mitigate dementia risk.