TY - JOUR
T1 - Re-examination of the risk of dementia after dengue virus infection
T2 - A population-based cohort study
AU - Chien, Yu Wen
AU - Shih, Hsin I.
AU - Wang, Yu Ping
AU - Chi, Chia Yu
N1 - Publisher Copyright:
© 2023 Chien et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2023/12
Y1 - 2023/12
N2 - Dengue infection can affect the central nervous system and cause various neurological complications. Previous studies also suggest dengue was associated with a significantly increased long-term risk of dementia. A population-based cohort study was conducted using national health databases in Taiwan and included 37,928 laboratory-confirmed den-gue patients aged ≥ 45 years between 2002 and 2015, along with 151,712 matched non-dengue individuals. Subdistribution hazard regression models showed a slightly increased risk of Alzheimer’s disease, and unspecified dementia, non-vascular dementia, and overall dementia in dengue patients than the nondengue group, adjusted for age, sex, area of resi-dence, urbanization level, income, comorbidities, and all-cause clinical visits within one year before the index date. After considering multiple comparisons using Bonferroni correction, only overall dementia and non-vascular dementia remained statistically significant (adjusted SHR 1.13, 95% CI 1.05–1.21, p = 0.0009; E-value 1.51, 95% CI 1.28-NA). Sensitivity analyses in which dementia cases occurring in the first three or five years after the index dates were excluded revealed no association between dengue and dementia. In conclusion, this study found dengue patients had a slightly increased risk of non-vascular dementia and total dementia than those without dengue. However, the small corresponding E-values and sensitivity analyses suggest the association between dengue and dementia may not be causal.
AB - Dengue infection can affect the central nervous system and cause various neurological complications. Previous studies also suggest dengue was associated with a significantly increased long-term risk of dementia. A population-based cohort study was conducted using national health databases in Taiwan and included 37,928 laboratory-confirmed den-gue patients aged ≥ 45 years between 2002 and 2015, along with 151,712 matched non-dengue individuals. Subdistribution hazard regression models showed a slightly increased risk of Alzheimer’s disease, and unspecified dementia, non-vascular dementia, and overall dementia in dengue patients than the nondengue group, adjusted for age, sex, area of resi-dence, urbanization level, income, comorbidities, and all-cause clinical visits within one year before the index date. After considering multiple comparisons using Bonferroni correction, only overall dementia and non-vascular dementia remained statistically significant (adjusted SHR 1.13, 95% CI 1.05–1.21, p = 0.0009; E-value 1.51, 95% CI 1.28-NA). Sensitivity analyses in which dementia cases occurring in the first three or five years after the index dates were excluded revealed no association between dengue and dementia. In conclusion, this study found dengue patients had a slightly increased risk of non-vascular dementia and total dementia than those without dengue. However, the small corresponding E-values and sensitivity analyses suggest the association between dengue and dementia may not be causal.
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U2 - 10.1371/journal.pntd.0011788
DO - 10.1371/journal.pntd.0011788
M3 - Article
C2 - 38055695
AN - SCOPUS:85179020289
SN - 1935-2727
VL - 2023-December
JO - PLoS neglected tropical diseases
JF - PLoS neglected tropical diseases
M1 - e0011788
ER -