Spinal cord injury and Alzheimer's disease risk: A population-based, retrospective cohort study article

Study design: Propensity score-matched, retrospective cohort study. Objectives: To determine the risk of developing Alzheimer's disease (AD) in patients with spinal cord injury (SCI). Setting: The present study used Taiwan's National Health Insurance Research Database. Methods: A total of 9257 patients who had 2 ambulatory visits with a diagnosis of SCI in 2001 were included in the SCI group. The non-SCI group consisted of 37,028 propensity score-matched patients without a diagnosis of SCI. The cumulative incidence of AD was estimated for each of the two patient groups using the Kaplan-Meier method. Stratified Cox proportional hazard regression was then employed to assess the influence of SCI on the risk of AD. Results: During the follow-up period, 25 subjects in the SCI group and 57 in the non-SCI group developed AD. The cumulative incidence of AD in the SCI group was higher than in the non-SCI group (P = 0.0168); and the hazard ratio of AD for the SCI group, as compared to the non-SCI group, was 1.71 (95% CI 1.06-2.76, P = 0.0273). Conclusions: This study suggests that patients with SCI have an increased risk of developing AD.