Hospitalization, surgery, and incident dementia

We evaluated whether hospitalization with or without surgery increases risk for dementia or Alzheimer's disease. A clinical sample (843 clinically diagnosed dementia cases; 1686 matched nondemented individuals) was identified from Swedish Twin Registry studies. A register-based sample (4293 cas...

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Bibliographic Details
Published in:	Alzheimer's & dementia Vol. 15; no. 4; pp. 534 - 542
Main Authors:	Eriksson, Lars I., Lundholm, Cecilia, Narasimhalu, Kaavya, Sandin, Rolf, Jin, Ya-Ping, Gatz, Margaret, Pedersen, Nancy L.
Format:	Journal Article
Language:	English
Published:	United States Elsevier Inc 01-04-2019
Subjects:	Aged Aged, 80 and over Alzheimer's disease APOE Apolipoproteins E - genetics Case-Control Studies Co-twin control Dementia Dementia - epidemiology Dementia - genetics Elective Surgical Procedures - statistics & numerical data Female Genetic Predisposition to Disease Genotype Hospitalization Humans Male Medicin och hälsovetenskap Middle Aged Nested case-control Registries Risk Factors Surgery Sweden - epidemiology Sweden Nested case-control Surgery Co-twin control Hospitalization APOE Alzheimer's disease Dementia
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Summary:	We evaluated whether hospitalization with or without surgery increases risk for dementia or Alzheimer's disease. A clinical sample (843 clinically diagnosed dementia cases; 1686 matched nondemented individuals) was identified from Swedish Twin Registry studies. A register-based sample (4293 cases; 21,465 matched controls) was identified by linkage of Swedish Twin Registry to Swedish Patient Registry records. Apolipoprotein E (APOE) status and within-pair comparisons of dementia discordant twins indicated genetic susceptibility. Nonsurgical hospitalization is associated with greater dementia risk than hospitalization with surgical intervention. In the register sample, thoracic, abdominal, and major orthopedic procedures entailed dementia risk; in the clinical sample, orthopedic alone. Within-pair analyses indicate that associations in part reflect genetic susceptibility in common to hospitalization and dementia. Potential gene-environment interactions were indicated by greater risk due to hospitalization among APOE ε4 noncarriers. We confirm hospitalization as a risk factor for dementia, with repeated hospitalizations a more important risk factor than surgery.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Contributors LIE, MG, Y-PJ, CL, and NLP conceived and designed the study. LIE, MG, and NLP obtained funding. CL performed the statistical analysis. All authors participated in the acquisition, analysis and interpretation of data. Y-PJ, CL, KN, and RS provided technical support. All authors critically revised the manuscript.
ISSN:	1552-5260 1552-5279 1552-5279
DOI:	10.1016/j.jalz.2018.12.005