Affiliations: [a] Celiac Disease Center, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA | [b] Department of Medical Epidemiology and Biostatistics, Karolinska University Hospital and Karolinska Institute, Stockholm, Sweden | [c] Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA | [d] Department of Epidemiology, Mailman School of Public Health, Columbia University Medical Center, New York, NY, USA | [e] Department of Pediatrics, Örebro University Hospital, Örebro, Sweden
Correspondence:
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Correspondence to: Benjamin Lebwohl, MD, MS, The Celiac Disease Center at Columbia University, 180 Fort Washington Avenue, Suite 936, New York, NY 10032, USA. Tel.: 212 305 5590; Fax: 212 305 3738; E-mail: BL114@columbia.edu
Abstract: Background:Patients with celiac disease (CD) frequently report cognitive symptoms when they are exposed to gluten, and cognitive deficits have been quantified in patients with newly diagnosed CD. Objective:To determine whether patients with CD have an increased risk of dementia. Methods:Using a population-based database of older adults (age ≥50 years) with histologically proven CD (duodenal/jejunal villous atrophy) from all 28 pathology departments in Sweden, we compared the incidence of a subsequent dementia diagnosis to those of age- and gender-matched controls. Results:Among patients with CD (n = 8,846) and controls (n = 43,474), the median age was 63 years and 56% were female. During a median follow-up time of 8.4 years, dementia was diagnosed in 4.3% of CD patients and 4.4% of controls (HR 1.07; 95% CI 0.95–1.20). Although there was an increased risk of dementia in the first year following a diagnosis of CD (HR 1.73; 95% CI 1.15–2.61), this risk was not present in the whole observation period. Among those subjects with a dementia subtype specified, the increased risk was restricted to vascular dementia (HR 1.28; 95% CI 1.00–1.64) and was not present for Alzheimer’s dementia (HR 1.12; 95% CI 0.91–1.37). Conclusions:Patients with CD are not at increased risk for dementia overall, though subgroup analysis suggests that they may be at increased risk for vascular dementia.
