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Updated: Jan 10, 2026
Using Retinal Imaging to Study Dementia
Published on: November 6, 2017
Microscopic colitis is associated with an increased risk of dementia in a Swedish population
Xiaoying Kang1,2,3, David Bergman1, Jiangwei Sun1
1Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden.
Background:
The microbiota-gut-brain axis has been implicated in dementia. Yet whether dementia is associated with microscopic colitis (MC), an age-related inflammatory colonic disease involving gut dysbiosis, remains unknown.
Methods:
Using the nationwide ESPRESSO cohort in Sweden, we compared MC patients histologically diagnosed 1990-2017 and aged ≥30 years to their population-based comparators and siblings, separately. MC association with incident and prevalent dementia diagnosis, respectively, was investigated in a matched cohort and a matched case-control design.
Findings:
Following 13,037 MC patients and 61,710 population comparators for a median of ∼10 years, we observed 4674 incident dementia cases (46% were Alzheimer's disease [AD]). During the first 5 years since biopsy, MC was associated with a 19% higher dementia risk (adjusted hazard ratio [aHR]: 1.19; 95% confidence interval [CI]: 1.07-1.32). This short-term association applied to both AD and vascular dementia and appeared stronger as compared to siblings (aHR: 1.55; 95% CI: 1.22-1.97). After 5 years, it attenuated to null in both comparisons, regardless of dementia subtype. Prior dementia was less prevalent in MC (adjusted odds ratio [aOR]: 0.73; 95% CI: 0.65-0.82). This inverse association was independent from medications commonly prescribed in MC but was not supported by sibling findings (aOR: 1.11; 95% CI: 0.81-1.51).
Conclusions:
MC patients may be more vulnerable to dementia diagnosis in early disease course. The intriguing inverse association between MC and preexisting dementia implies a possible underdiagnosis of MC in demented population and warrants further investigation.
Insights
Microscopic colitis (MC) patients show a higher risk of dementia diagnosis within five years of their condition. However, MC patients had less prevalent pre-existing dementia, suggesting possible underdiagnosis.
Area of Science:
- Gastroenterology
- Neurology
- Epidemiology
Background:
- The gut-brain axis is linked to dementia.
- Microscopic colitis (MC) is an age-related inflammatory bowel disease associated with gut dysbiosis.
- The relationship between MC and dementia is currently unknown.
Purpose of the Study:
- To investigate the association between microscopic colitis and dementia.
- To explore the temporal relationship between MC diagnosis and dementia incidence.
- To examine the prevalence of pre-existing dementia in MC patients.
Main Methods:
- A nationwide cohort study in Sweden (ESPRESSO) was used, including MC patients and population-based comparators and siblings.
- Matched cohort and case-control designs were employed to assess incident and prevalent dementia, respectively.
- Data spanned diagnoses from 1990-2017 for patients aged 30 years and older.
Main Results:
- MC patients had a 19% increased dementia risk within 5 years post-diagnosis (aHR: 1.19), including Alzheimer's disease and vascular dementia.
- This short-term risk elevation was more pronounced when compared to siblings (aHR: 1.55).
- After 5 years, the association attenuated to null. Pre-existing dementia was less common in MC patients (aOR: 0.73), an association not observed in sibling comparisons.
Conclusions:
- Microscopic colitis patients may face an elevated risk of dementia diagnosis early in the disease course.
- An inverse association between MC and pre-existing dementia suggests potential underdiagnosis of MC in individuals with dementia.
- Further research is warranted to explore the implications of MC on dementia risk and diagnosis.
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