Affiliations: [a]
Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, USA
| [b]
Indiana University Center for Health Innovation and Implementation Science, School of Medicine, Indianapolis, IN, USA
Correspondence:
[*]
Correspondence to: Jing Su, PhD, and Pengyue Zhang, PhD, Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, USA. Tel.: + 1 317 278 2950; E-mail: su1@iu.edu; (JS) Tel.: +1 317 278 2930; zhangpe@iu.edu(PZ).
Note: [1] These authors contributed equally to this work.
Abstract: Background:Early detection of Alzheimer’s disease (AD) is a key component for the success of the recently approved lecanemab and aducanumab. Patients with neuroinflammation-related conditions are associated with a higher risk for developing AD. Objective:Investigate the incidence of AD among patients with neuroinflammation-related conditions including epilepsy, hemorrhage stroke, multiple sclerosis (MS), and traumatic brain injury (TBI). Methods:We used Optum’s de-identified Clinformatics Data Mart Database (CDM). We derived covariate-matched cohorts including patients with neuroinflammation-related conditions and controls without the corresponding condition. The matched cohorts were: 1) patients with epilepsy and controls (N = 67,825 matched pairs); 2) patients with hemorrhage stroke and controls (N = 81,510 matched pairs); 3) patients with MS and controls (N = 9,853 matched pairs); and 4) patients TBI and controls (N = 104,637 matched pairs). We used the Cox model to investigate the associations between neuroinflammation-related conditions and AD. Results:We identified that epilepsy, hemorrhage stroke, and TBI were associated with increased risks of AD in both males and females (hazard ratios [HRs]≥1.74, p < 0.001), as well as in gender- and race-conscious subpopulations (HRs≥1.64, p < 0.001). We identified that MS was associated with increased risks of AD in both males and females (HRs≥1.47, p≤0.004), while gender- and race-conscious subgroup analysis shown mixed associations. Conclusions:Patients with epilepsy, hemorrhage stroke, MS, and/or TBI are associated with a higher risk of developing AD. More attention on cognitive status should be given to older patients with these conditions.
