TY - JOUR
T1 - Association of Alopecia Areata and the Risk of Dementia
T2 - A Nationwide Cohort Study
AU - Li, Cheng Yuan
AU - Tai, Ying Hsuan
AU - Dai, Ying Xiu
AU - Chang, Yun Ting
AU - Bai, Ya Mei
AU - Tsai, Shih Jen
AU - Chen, Tzeng Ji
AU - Chen, Mu Hong
N1 - Funding Information:
The study was supported by grant from Taipei Veterans General Hospital (V106B-020, V107B-010, V107C-181, V108B-012, V110C-025, V110B-002) and Ministry of Science and Technology, Taiwan (107-2314-B-075-063-MY3, 108-2314-B-075-037, 110-2314-B-075-026, 110-2314-B-075-024-MY3).
Publisher Copyright:
© Copyright 2021 Physicians Postgraduate Press, Inc.
PY - 2021/11
Y1 - 2021/11
N2 - Background: Alopecia areata (AA) is associated with multiple comorbidities and shares a similar inflammatory signature with dementia. The great negative psychosocial impact of AA may result in poor social engagement, a typical risk factor for dementia. However, little is known about the association between AA and dementia. Methods: Via the Taiwan National Health Insurance Research Database, 2,534 patients with AA (International Classification of Diseases, 9th Revision, Clinical Modification code: 704.01) aged ≥ 45 years and 25,340 controls matched for age, sex, residence, income, dementia-related comorbidities, systemic steroid use, and annual outpatient visit were included between 1998 and 2011 for investigation of subsequent dementia from enrollment to the end of 2013. After controlling for potential confounders, stratified Cox regression analysis on each matched pair was applied to assess the dementia risk between the AA and control groups. Results: Patients with AA were more likely to develop any dementia (adjusted hazard ratio [aHR] = 3.24; 95% CI, 2.14-4.90), Alzheimer's disease (aHR = 4.34; 95% CI, 1.45-12.97), and unspecified dementia (aHR = 3.36; 95% CI, 2.06-5.48) than the control cohort. Stratification analysis by age and sex revealed increased risks of any dementia and unspecified dementia in both age groups (ie, < 65 and ≥ 65 years) and both sex groups and increased risks of AD in male patients and in those with age at dementia onset ≥ 65 years. Sensitivity analyses after exclusion of the first year or first 3 years of observation showed consistent findings. Conclusions: Patients with AA had a higher risk of developing dementia. Further studies are needed to elucidate the underlying pathophysiology between AA and dementia risk.
AB - Background: Alopecia areata (AA) is associated with multiple comorbidities and shares a similar inflammatory signature with dementia. The great negative psychosocial impact of AA may result in poor social engagement, a typical risk factor for dementia. However, little is known about the association between AA and dementia. Methods: Via the Taiwan National Health Insurance Research Database, 2,534 patients with AA (International Classification of Diseases, 9th Revision, Clinical Modification code: 704.01) aged ≥ 45 years and 25,340 controls matched for age, sex, residence, income, dementia-related comorbidities, systemic steroid use, and annual outpatient visit were included between 1998 and 2011 for investigation of subsequent dementia from enrollment to the end of 2013. After controlling for potential confounders, stratified Cox regression analysis on each matched pair was applied to assess the dementia risk between the AA and control groups. Results: Patients with AA were more likely to develop any dementia (adjusted hazard ratio [aHR] = 3.24; 95% CI, 2.14-4.90), Alzheimer's disease (aHR = 4.34; 95% CI, 1.45-12.97), and unspecified dementia (aHR = 3.36; 95% CI, 2.06-5.48) than the control cohort. Stratification analysis by age and sex revealed increased risks of any dementia and unspecified dementia in both age groups (ie, < 65 and ≥ 65 years) and both sex groups and increased risks of AD in male patients and in those with age at dementia onset ≥ 65 years. Sensitivity analyses after exclusion of the first year or first 3 years of observation showed consistent findings. Conclusions: Patients with AA had a higher risk of developing dementia. Further studies are needed to elucidate the underlying pathophysiology between AA and dementia risk.
UR - http://www.scopus.com/inward/record.url?scp=85138800955&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85138800955&partnerID=8YFLogxK
U2 - 10.4088/JCP.21m13931
DO - 10.4088/JCP.21m13931
M3 - Article
AN - SCOPUS:85138800955
SN - 0160-6689
VL - 82
JO - Journal of Clinical Psychiatry
JF - Journal of Clinical Psychiatry
IS - 6
M1 - 21m13931
ER -