Association between dementia risk and ulcerative colitis, with and without colectomy: a Swedish population-based register study

Objective This study aims to investigate the association of ulcerative colitis (UC) with all-cause dementia and assess differences in those with and without a total colectomy.Design, setting and participants This Swedish prospective register-based study comprised 4.8 million individuals aged at leas...

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Main Authors: Scott Montgomery, Ayako Hiyoshi, Miguel Garcia-Argibay
Format: Article
Language:English
Published: BMJ Publishing Group 2023-12-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/13/12/e074110.full
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author Scott Montgomery
Ayako Hiyoshi
Miguel Garcia-Argibay
author_facet Scott Montgomery
Ayako Hiyoshi
Miguel Garcia-Argibay
author_sort Scott Montgomery
collection DOAJ
description Objective This study aims to investigate the association of ulcerative colitis (UC) with all-cause dementia and assess differences in those with and without a total colectomy.Design, setting and participants This Swedish prospective register-based study comprised 4.8 million individuals aged at least 59 years between 1964 and 2018 with the linkage of several Swedish national registers.Primary and secondary outcome measures Individuals with dementia were defined according to International Classification of Diseases diagnostic codes and Anatomical Therapeutic Classification codes for medication prescriptions. Fitting Cox hazards models, the risk of developing all-cause dementia in individuals with and without UC was estimated. Further, we compared the risk of all-cause dementia among those with and without a colectomy.Results Among 4 821 488 individuals (52.6% females) followed for 84.1 million person-years between 1964 and 2018, the incidence rate of all-cause dementia was 63.90 (63.73–64.07) events per 10 000 person-years in individuals without UC, 94.80 (92.04–97.64) among those with UC, 95.01 (92.25–97.86) in those with UC but without colectomy and 63.42 (40.92–98.31) in those with UC and a colectomy. Adjusted Cox models showed an increased all-cause dementia risk in individuals with UC (HR 1.07, 95% CI 1.04 to 1.10). We found no differences between unexposed individuals and those with UC and a colectomy (HR 0.89, 95% CI 0.57 to 1.38).Conclusion The findings are consistent with previous evidence suggesting a slightly increased dementia risk among individuals with UC. This study provided no evidence of further risk increase of dementia among those who had a colectomy.
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spelling doaj-art-eb0d56dbdac24abe8c21dc6b5282ce0c2025-08-20T03:52:29ZengBMJ Publishing GroupBMJ Open2044-60552023-12-01131210.1136/bmjopen-2023-074110Association between dementia risk and ulcerative colitis, with and without colectomy: a Swedish population-based register studyScott Montgomery0Ayako Hiyoshi1Miguel Garcia-Argibay2Clinical Epidemiology and Biostatistics, Örebro Universitet—Campus USÖ, Orebro, SwedenClinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, SwedenSchool of Medical Sciences, Örebro University, Orebro, SwedenObjective This study aims to investigate the association of ulcerative colitis (UC) with all-cause dementia and assess differences in those with and without a total colectomy.Design, setting and participants This Swedish prospective register-based study comprised 4.8 million individuals aged at least 59 years between 1964 and 2018 with the linkage of several Swedish national registers.Primary and secondary outcome measures Individuals with dementia were defined according to International Classification of Diseases diagnostic codes and Anatomical Therapeutic Classification codes for medication prescriptions. Fitting Cox hazards models, the risk of developing all-cause dementia in individuals with and without UC was estimated. Further, we compared the risk of all-cause dementia among those with and without a colectomy.Results Among 4 821 488 individuals (52.6% females) followed for 84.1 million person-years between 1964 and 2018, the incidence rate of all-cause dementia was 63.90 (63.73–64.07) events per 10 000 person-years in individuals without UC, 94.80 (92.04–97.64) among those with UC, 95.01 (92.25–97.86) in those with UC but without colectomy and 63.42 (40.92–98.31) in those with UC and a colectomy. Adjusted Cox models showed an increased all-cause dementia risk in individuals with UC (HR 1.07, 95% CI 1.04 to 1.10). We found no differences between unexposed individuals and those with UC and a colectomy (HR 0.89, 95% CI 0.57 to 1.38).Conclusion The findings are consistent with previous evidence suggesting a slightly increased dementia risk among individuals with UC. This study provided no evidence of further risk increase of dementia among those who had a colectomy.https://bmjopen.bmj.com/content/13/12/e074110.full
spellingShingle Scott Montgomery
Ayako Hiyoshi
Miguel Garcia-Argibay
Association between dementia risk and ulcerative colitis, with and without colectomy: a Swedish population-based register study
BMJ Open
title Association between dementia risk and ulcerative colitis, with and without colectomy: a Swedish population-based register study
title_full Association between dementia risk and ulcerative colitis, with and without colectomy: a Swedish population-based register study
title_fullStr Association between dementia risk and ulcerative colitis, with and without colectomy: a Swedish population-based register study
title_full_unstemmed Association between dementia risk and ulcerative colitis, with and without colectomy: a Swedish population-based register study
title_short Association between dementia risk and ulcerative colitis, with and without colectomy: a Swedish population-based register study
title_sort association between dementia risk and ulcerative colitis with and without colectomy a swedish population based register study
url https://bmjopen.bmj.com/content/13/12/e074110.full
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