Septicemia is associated with increased risk for dementia: a population-based longitudinal study

Abstract

BackgroundSystemic infection has been linked to cognitive impairment. We hypothesized that patients with septicemia are predisposed to increased risks for developing dementia in a long-term setting.MethodsThis observational, retrospective, longitudinal, nation-wide population-based study was conducted using the data deduced from Longitudinal Health Insurance Database (LHID) in Taiwan. All patients with septicemia hospitalized for the first time from 2001 to 2011 without prior dementia were included. The development of Alzheimer's disease (AD) or non-Alzheimer dementias (NAD) in relation to the development of septicemia for each patient was recorded. An age- and sex-matched cohort without septicemia and without prior dementia served as the control. Septicemia, dementia, and other confounding factors were defined according to International Classification of Diseases Clinical Modification Codes. Cox proportional-hazards regressions were utilized to analyze adjusted hazard ratios.ResultsPatients with septicemia had a higher risk for developing dementia based on hazard ratios (HRs) (p<0.001). Patients with septicemia in the younger age groups had a greater dementia risk (p<0.01). Septicemia was associated with subsequent NAD (p<0.001), whereas the increased risk of AD was statistically insignificant (p>0.05). Furthermore, higher severity of septicemia was associated with increased risk of developing dementia.ConclusionsOur findings suggest that septicemia is associated with an increased risk in developing NAD but not AD. A likely causal role of septicemia in increasing the risk of NAD is suggested, according to the findings that patients with higher severity of septicemia carried greater risk of sustaining dementia.

The Physiological Roles of Amyloid-β Peptide Hint at New Ways to Treat Alzheimer's Disease

“…Notably, Aß returned to normal levels after the C. pneumoniae infection had resolved. In addition, wild-type mice infected with persistent cerebral toxocariasis acquire insoluble Aß deposits in the hippocampus at concentrations 10–20-fold higher than in uninfected mice (Chou et al, 2017 ). The presence of Aß deposits in non-transgenic mice is significant because it may provide insight into the presence of Aß in the 95% or more AD patients who have non-hereditary “sporadic” AD.…”

Common Bacterial Infections and Risk of Dementia or Cognitive Decline: A Systematic Review

“…Finally, 9 studies were included in the present systematic review. The study characteristics and results are summarized in Tables 1 and 2 Of the studies included, six studies were conducted in the United States [22][23][24][25][26][27], and three in Taiwan [28][29][30]. Four were historical cohort studies, which used data derived from electronic health records [22,25,28,29], two were prospective cohort studies [23,26], one was a secondary analysis from a randomized controlled trial [24], and two were case-control studies [27,30].…”

“…In total, seven studies investigated sepsis [22,23,25,[27][28][29][30], four assessed pneumonia [23][24][25][26], and only one study considered urinary tract infections and cellulitis [25]. Two studies investigated the effect of multiple infections on dementia [23,25].…”

Effects of sepsis on hippocampal volume and memory function

“…Sepsis patients have a higher risk of non-Alzheimer's dementia compared with the general population. [15,16] At present, most clinical diagnoses of SAE are based only on clinical manifestations without electrophysiological or biochemical tests. As a result, many sepsis patients with hidden neurological dysfunction do not undergo comprehensive neuropsychological tests because they do not have signifi cant psychiatric disorders in hospitals.…”