Risk of Major Types of Dementias Following Hospital-Diagnosed Infections and Autoimmune Diseases

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  • Janet Janbek
  • Thomas Munk Laursen
  • Niels Frimodt-Møller
  • Melinda Magyari
  • Jürgen G. Haas
  • Richard Lathe
  • Waldemar, Gunhild
Background:
Population-based studies have shown an increased risk of dementia after infections, but weaker links were reported for autoimmune diseases. Evidence is scarce for whether the links may be modified by the dementia or exposure subtype.

Objective:
We aimed to investigate the association between infections and/or autoimmune diseases and rates of major types of dementias in the short- and long terms.

Methods:
Nationwide nested case-control study of dementia cases (65+ years) diagnosed in Denmark 2016–2020 and dementia-free controls. Exposures were hospital-diagnosed infections and autoimmune diseases in the preceding 35 years. Two groups of dementia cases were those diagnosed in memory clinics (MC) and those diagnosed outside memory clinics (non-memory clinic cases, NMC).

Results:
In total, 26,738 individuals were MC and 12,534 were NMC cases. Following any infection, the incidence rate ratio (IRR) for MC cases was 1.23 (95% CI 1.20–1.27) and 1.70 for NMC cases (1.62–1.76). Long-term increased rates were seen for vascular dementia and NMC cases. IRRs for autoimmune diseases were overall statistically insignificant.

Conclusions:
Cases with vascular dementia and not Alzheimer’s disease, and a subgroup of cases identified with poorer health have increased long-term risk following infections. Autoimmune diseases were not associated with any type of dementia. Notably increased risks (attributed to the short term) and for NMC cases may indicate that immunosenescence rather than de novo infection explains the links. Future focus on such groups and on the role of vascular pathology will explain the infection-dementia links, especially in the long term.
OriginalsprogEngelsk
TidsskriftJournal of Alzheimer's Disease
Vol/bind98
Udgave nummer4
Sider (fra-til)1503-1514
Antal sider12
ISSN1387-2877
DOI
StatusUdgivet - 2024

Bibliografisk note

Funding Information:
The Danish Dementia Research Centre is supported by the Danish Ministry of Health which had no role in the current study.

Publisher Copyright:
© 2024 – The authors. Published by IOS Press. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (CC BY-NC 4.0).

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