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Increased risk of dementia among chronic osteomyelitis patients

European Journal of Clinical Microbiology & Infectious Diseases volume 34, pages 153–159 (2015)Cite this article

Abstract

Inflammatory processes may trigger neuroinflammation and cerebrovascular dysfunctions, further provoking dementia. The role of chronic osteomyelitis (COM), a disorder characterized by persistent inflammation, in dementia development has not been fully explored. This study investigates whether COM increases the risk of dementia. Taiwanese National Health Insurance (NHI) inpatient claims were used to identify 17,238 patients newly diagnosed with COM from 2000 to 2008, and 68,944 age- and gender-matched patients without COM were randomly selected for comparison. Risks of dementia associated with COM and comorbidities, including hypertension, diabetes, stroke, hyperlipidemia, and depression, were evaluated using data from the end of 2011. Dementia risk was 1.6-fold higher (95 % confidence interval [CI]: 1.4–1.83) in the COM cohort than in the control group, calculated using the multivariable Cox model. Age-specific analysis indicated that the adjusted hazard ratios (aHRs) of dementia for COM patients decreased with age, with an aHR of 3.65 (95 % CI: 1.5–8.9) for patients <55 years old, which gradually decreased to 1.43 (95 % CI: 1.23–1.66) for patients ≥70 years old. Dementia risk increased with COM severity, with an aHR of 5.48 (95 % CI: 4.43–6.79) for patients with severe COM. For those without comorbidities, dementia risk was 1.73-fold (95 % CI: 1.37–2.17) higher in the COM cohort than in the control group. This study is the first to find that COM is an inflammatory disorder associated with an increased risk of dementia, particularly among younger people.

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Acknowledgments

The authors thank the National Health Research Institute in Taiwan for making available the insurance claims data for analyses. We also thank Professors Chi-Pang Wen and Chung Y. Hsu for their critical comments.

Funding and grant support

This work was supported by the study projects of China Medical University Hospital (DMR-103-012 and DMR-103-020); Taiwan Ministry of Health and Welfare Clinical Trial and Research Center of Excellence (MOHW103-TDU-B-212-113002); Health and welfare surcharge of tobacco products, China Medical University Hospital Cancer Research Center of Excellence (MOHW103-TD-B-111-03, Taiwan). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. No additional external funding was received for this study.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Affiliations

  1. Department of Neurology, China Medical University Hospital, Taichung, Taiwan

    C.-H. Tseng & W.-S. Huang

  2. Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, No. 2, Yuh-Der Road, Taichung, 40447, Taiwan

    C.-H. Tseng, W.-S. Huang & C.-H. Kao

  3. Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan

    C.-H. Muo

  4. Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan

    C.-H. Kao

Authors
  1. C.-H. Tseng
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  2. W.-S. Huang
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  3. C.-H. Muo
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  4. C.-H. Kao
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Corresponding author

Correspondence to C.-H. Kao.

Additional information

Chun-Hung Tseng and Wei-Shih Huang contributed equally to this work.

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Tseng, CH., Huang, WS., Muo, CH. et al. Increased risk of dementia among chronic osteomyelitis patients. Eur J Clin Microbiol Infect Dis 34, 153–159 (2015). https://doi.org/10.1007/s10096-014-2200-1

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  • DOI: https://doi.org/10.1007/s10096-014-2200-1

Keywords

  • Dementia
  • National Health Insurance
  • Control Cohort
  • Chronic Osteomyelitis
  • Dementia Risk