Affiliations: [a] Department of Medicine ‘B’, Sheba Medical Center, Tel-Hashomer, Israel | [b]
The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel | [c] Sackler Faculty of Medicine, Tel-Aviv University, Israel | [d] Department of Health Sciences (DISSAL), School of Public Health, University of Genoa, Genoa, Italy | [e] Chief Physician’s Office, Clalit Health Services Tel Aviv, Faculty of Health Sciences, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel | [f] Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
Correspondence:
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Correspondence to: Howard Amital, MD, MHA, Head of Department of Medicine ‘B’, Sheba Medical Center, Tel-Hashomer, 52621, Israel. Tel.: +972 3 530 2652; Fax: +972 3 535 4796; E-mail: howard.amital@sheba.health.gov.il.
Note: [1] These authors contributed equally to this work.
Abstract: Background:Neurological features are often overlooked in systemic sclerosis (SSc) patients and little is known about the link between dementia and SSc. Objectives:We sought to investigate whether an association exists between Alzheimer’s disease (AD) and SSc, as well as assess the impact of a dual diagnosis on mortality rates, by performing an extensive data analysis on a large subject sample. Methods:We utilized the medical database of the Clalit-Health-Services in a case-control study. Patients with SSc were compared with age- and sex-matched controls with regard to the prevalence of AD and its impact on their mortality. Results:Our study included 2,431 SSc patients and 12,377 age- and sex-matched controls. The mean age of the study population was 63.32±18.06 years and the female to male ratio was 4.5:1. 134 (5.5%) cases had AD as a co-morbidity in comparison with 749 (5.9%) of the controls. The mortality rate was 12.5% among controls and 26.2% among SSc cases. On the Cox multivariate survival analysis, diagnosis of SSc and AD demonstrated significant HRs (2.35 (95% CI 2.05–2.69, p < 0.0001) and 2.19 (95% CI 1.94–2.48, p < 0.0001), respectively). SSc patients with AD had a relative risk of death of 2.35 (95% CI: 1.44–3.83) in comparison with SSc patients without AD. Conclusion:AD is a predictor of death in SSc and therefore preemptive screening may be warranted. Further studies are needed to evaluate whether improvements in the medical regimen for SSc may lead to a reduction in AD development and possibly to increased survival as well.
