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Glomerular hyperfiltration is associated with dementia: A nationwide population-based study.

ABSTRACT: BACKGROUND:Glomerular hyperfiltration may be a clinical phenotype of endothelial dysfunction. Endothelial dysfunction may cause vascular dementia through the deterioration of cerebral blood flow. We aimed to identify the risk of dementia in people with glomerular hyperfiltration. METHODS:Using the Korean National Health Information Database, we included subjects aged ?45 years who underwent national health screening examinations between 2012 and 2015 and who had no previous history of end-stage renal disease or dementia (n = 2,244,582). The primary exposure was glomerular hyperfiltration. We divided the subjects into groups by sex and five-year age intervals and categorized each group into 8 intervals according to estimated glomerular filtration (eGFR). The subjects with an eGFR ?95th percentile in each group were defined as the hyperfiltration group. The outcomes were development of all types of dementia, Alzheimer's dementia and vascular dementia. Multivariable Cox proportional hazards models were used to analyze the hazard ratios (HRs) for outcomes. RESULTS:The Hyperfiltration group showed a higher risk for the development of all types of dementia [adjusted HR 1.09 (95% CI, 1.03-1.15)] and vascular dementia [adjusted HR 1.33 (95% CI, 1.14-1.55)] than the reference group. However, the association between hyperfiltration and Alzheimer's dementia was not statistically significant. CONCLUSIONS:Glomerular hyperfiltration may be associated with dementia. In this respect, subjects with glomerular hyperfiltration should be monitored more closely for signs and symptoms of dementia.

SUBMITTER: Kang MW

PROVIDER: S-EPMC6986766 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Glomerular hyperfiltration is associated with dementia: A nationwide population-based study.

Kang Min Woo MW Park Sehoon S Lee Soojin S Lee Yeonhee Y Cho Semin S Han Kyungdo K Cho Hanna H Kim Yaerim Y Kim Yong Chul YC Han Seung Seok SS Lee Hajeong H Lee Jung Pyo JP Joo Kwon Wook KW Lim Chun Soo CS Kim Yon Su YS Kim Dong Ki DK

PloS one 20200128 1

<h4>Background</h4>Glomerular hyperfiltration may be a clinical phenotype of endothelial dysfunction. Endothelial dysfunction may cause vascular dementia through the deterioration of cerebral blood flow. We aimed to identify the risk of dementia in people with glomerular hyperfiltration.<h4>Methods</h4>Using the Korean National Health Information Database, we included subjects aged ≥45 years who underwent national health screening examinations between 2012 and 2015 and who had no previous histor ...[more]

PMID: 31990949

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Project description:PURPOSE:The association between primary headaches, including tension-type headache (TTH) as one of the most common primary headache disorders, and dementia remains controversial. In this nationwide, population-based, retrospective, cohort study, we explored the potential association between TTH and dementia and examined sex, age, and comorbidities as risk factors for dementia. METHODS:Using the Taiwan National Health Insurance Research Database (NHIRD) claims data, the sample included 13908 subjects aged ?20 years with newly-diagnosed TTH in 2000-2006. The non-TTH group included 55632 randomly selected sex- and age-matched TTH-free individuals. All subjects were followed until dementia diagnosis, death, or the end of 2011. Patients with dementia, including vascular and non-vascular (including Alzheimer's) subtypes, were identified using International Classification of Diseases Ninth Revision, Clinical Modification codes. Multivariate Cox proportional hazards regression models were used to assess the risk of dementia and dementia-associated risk factors, such as migraine and other medical comorbidities. RESULTS:During the average follow-up of 8.14 years, the incidence density rates of dementia were 5.30 and 3.68/1,000 person-years in the TTH and non-TTH groups, respectively. Compared with the non-TTH group, the risks of dementia were 1.25 (95% confidence interval [CI], 1.11-1.42) and 1.13 (95% CI, 1.01-1.27) times higher in the women and >65-year-old TTH group, respectively. TTH patients with comorbidities had a higher risk of dementia. TTH patients had a greater risk of non-vascular dementia (hazard ratio, 1.21; 95% CI, 1.09-1.34) than the non-TTH group. CONCLUSION:TTH patients have a future risk of dementia, indicating a potentially linked disease pathophysiology that warrants further study. The association between TTH and dementia is greater in women, older adults, and with comorbidities. Clinicians should be aware of potential dementia comorbidity in TTH patients.

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Glomerular hyperfiltration is associated with dementia: A nationwide population-based study.

Publications

Glomerular hyperfiltration is associated with dementia: A nationwide population-based study.

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