期刊
ALZHEIMERS & DEMENTIA
卷 15, 期 4, 页码 534-542出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jalz.2018.12.005
关键词
Dementia; Alzheimer's disease; Hospitalization; Surgery; Nested case-control; Co-twin control; APOE
资金
- National Institutes of Health [R01 AG08724]
- Swedish Research Council [521-2011-152, 2015-02776]
- Torsten Soderberg Foundation
- Stockholm County Council ALF [20140188]
- Brain Foundation, Sweden
- Swedish Research Council [2015-02776] Funding Source: Swedish Research Council
Introduction: We evaluated whether hospitalization with or without surgery increases risk for dementia or Alzheimer's disease. Methods: A clinical sample (843 clinically diagnosed dementia cases; 1686 matched nondemented individuals) was identified from Swedish Twin Registry studies. A register-based sample (4293 cases; 21,465 matched controls) was identified by linkage of Swedish Twin Registry to Swedish Patient Registry records. Apolipoprotein E (APOE) status and within-pair comparisons of dementia discordant twins indicated genetic susceptibility. Results: Nonsurgical hospitalization is associated with greater dementia risk than hospitalization with surgical intervention. In the register sample, thoracic, abdominal, and major orthopedic procedures entailed dementia risk; in the clinical sample, orthopedic alone. Within-pair analyses indicate that associations in part reflect genetic susceptibility in common to hospitalization and dementia. Potential gene-environment interactions were indicated by greater risk due to hospitalization among APOE epsilon 4 noncarriers. Discussion: We confirm hospitalization as a risk factor for dementia, with repeated hospitalizations a more important risk factor than surgery. (C) 2019 The Authors. Published by Elsevier Inc. on behalf of the Alzheimer's Association.
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