Incidence of dementia after dengue fever: Results of a longitudinal population‐based study

Abstract

Objective: To investigate the epidemiological relationship between dengue fever and the subsequent development of dementia.Methods: Using nationwide Taiwan registries from the National Health Insurance Research (NHIRD), we identified adults aged over 40 years who received a dengue fever diagnosis from 1 January 2000 to 31 December 2012 and who did not have a history of dementia. We used a propensity score match (PSM) to balance the baseline characteristics between groups. All eligible adults were sorted into either the dengue group or non-dengue group at a ratio of 1:4, matching by age, sex, index years, income level, and relevant comorbidities. Using Cox regression with proportional hazards models, we estimated the risk of dementia. The study period started from 1 January 2000 to 31 December 2013. We conducted sensitivity analyses to cross-validate study results.Results: With a median of 8.01 years of follow-up, patients in the dengue group were more at risk of developing dementia than the non-dengue group. The estimated cumulative incidence of dementia was 7.21% in the dengue group and 4.03% in the nondengue group (adjusted hazard ratio (aHR), 1.71; 95% CI, 1.03 to 2.83). Sensitivity analyses yielded consistent findings. We excluded any stroke cases before the end of the study, and subgroup analysis by follow-up time showed that the dengue group This nationwide retrospective cohort study showed an increased risk of dementia amongst patients with dengue virus infection. This is an important issue because infection-associated dementia could potentially be prevented by vaccines, screening programmes, and other preventive measures.

Re-examination of the risk of dementia after dengue virus infection: A population-based cohort study

“…evidence to support a causal link between DENV infection and dementia. Our findings contrast with two previous studies that reported more substantial association between dengue and dementia (HRs of 2.23 and 1.71), where the associations remained statistically significant in sensitivity analyses [6,7]. Several factors could account for these discrepancies.…”

“…In addition to these neurological disorders during acute infection, two previous studies have investigated whether DENV infection had a long-term effect on the risk of developing dementia using the National Health Insurance Research Database (NHIRD) in Taiwan. The results showed that dengue patients had a significantly higher risk of dementia than people without dengue, with adjusted hazard ratios of 2.23 [95% confidence interval (CI) 1.51-3.53] [6] and 1.71 (95% CI 1.03-2.83) [7], respectively. However, dengue cases in these two studies were identified based on clinical diagnosis, not laboratory-confirmed.…”