IntroductionIt is known that biological risk factors and lifestyle behaviors are important determinants of dementia. However, there has been yet to be sufficient evidence to prove that community-level social capital is one of the determinants of dementia. This retrospective cohort study is a large, long-term, population-based study that investigated the association between community-level social trust and the risk of dementia in the Republic of Korea.MethodsData came from the Korean National Health Insurance Service database. The community-level social trust values were determined by the Korean Community Health Survey. The study population consisted of 1,974,944 participants over 50 years of age and was followed up from 1 January 2012 to 31 December 2019 with a latent period of 5 years from 1 January 2012 to 31 December 2016. Cox proportional hazards regression was utilized to obtain the adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for the risk of dementia according to social trust quintiles.ResultsParticipants within the highest quintile of community-level social trust had a lower risk for overall dementia (aHR, 0.90; 95% CI, 0.86–0.94) and Alzheimer's disease (aHR, 0.90; 95% CI, 0.85–0.94) compared to those within the lowest quintile of community-level social trust. The alleviating trend association of high community-level social trust on dementia risk was maintained regardless of whether the participants had health examinations.ConclusionsOur findings suggest that higher community-level social trust is associated with a reduced risk of dementia. Community-level social trust is a crucial indicator of dementia and improving community-level social trust may lead to a lower risk of dementia.
Background Several studies suggest that antibiotic use may affect overall cancer incidence, but the association between antibiotics and prostate cancer is still unclear. Methods A population-based retrospective cohort study was conducted using the Korean National Health Insurance Service (NHIS) database. 1,032,397 individuals were followed up from January 1, 2007, to December 31, 2019. Multivariate Cox hazards regression was utilized to calculate adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for the risk of prostate cancer according to accumulative days of antibiotic use and the number of antibiotic classes used. Results Individuals who used antibiotics for 180 or more days had a higher risk of prostate cancer (aHR, 1.46; 95% CI, 1.11-1.91) than those who did not use antibiotics. Also, individuals who used four or more kinds of antibiotics had a higher risk of prostate cancer (aHR, 1.18; 95% CI, 1.07-1.30) than antibiotic non-users. A similar trend was observed among participants who underwent health examinations. Conclusion Our findings suggest that long-term use of antibiotics may affect prostate cancer incidence. Further studies are needed to improve understanding of the association between antibiotic use and prostate cancer incidence.
Background Several previous studies reported that antibiotic exposure in early life could lead to asthma in early childhood. However, the association between antibiotic use and the risk of asthma in the adult population is yet unclear. Our study aims to investigate the association between antibiotic use and asthma in adults. Methods National Health Insurance Service-Health Screening Cohort data, which included 40 years or older aged subjects who have health screening examination data in 2005–2006, were used. Antibiotic exposure was examined from 2002 to 2006 and in total 256,698 participants with a mean age of 55.66 years were followed up from 2007 to 2019. During the follow-up period, 47,500 participants occurred asthma. To assess this association between antibiotic use and newly diagnosed asthma, the multivariable cox proportional hazards regression model was used. The considered covariates included residence status, body mass index, the number of healthcare visits, previous atopic dermatitis history, previous allergic rhinitis history, and infectious diseases. Results Participants with antibiotics use for ≥ 91 days showed a higher risk of asthma (adjusted hazard ratio [aHR] 1.88, 95% confidence interval [CI] 1.77-2.00), with a clear dose-dependent association (p for trend < 0.001). Furthermore, ≥ 4 antibiotic classes used group had an increased risk of asthma (aHR 1.67, 95% CI 1.58–1.76) than those who used only one antibiotic class. In our sensitivity analysis with wash-out period and shifting the index date, increased risk of asthma incidence and clear dose-response relationship according to antibiotics use have remained. Conclusions The clear dose-response pattern in antibiotics use and asthma may suggest that the management of proper antibiotic use in adults may lower the risk of asthma in the future.
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