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Thalassemia and risk of dementia: A nationwide population-based retrospective cohort study

  • Yu-Guang Chen
    Affiliations
    Division of Hematology/Oncology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
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  • Te-Yu Lin
    Affiliations
    Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
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  • Hsuan-Ju Chen
    Affiliations
    Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan

    College of Medicine, China Medical University, Taichung, Taiwan
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  • Ming-Shen Dai
    Affiliations
    Division of Hematology/Oncology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
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  • Ching-Liang Ho
    Affiliations
    Division of Hematology/Oncology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
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  • Chia-Hung Kao
    Correspondence
    Corresponding author at: Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, No. 2, Yuh-Der Road, Taichung 40447, Taiwan. Tel.: +886 4 22052121x7412; fax: +886 4 22336174.
    Affiliations
    Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taiwan

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

      • The risks for developing dementia were 1.88-fold in patients with thalassemia.
      • The HRs of dementia increased from 1.69 for who had not transfusion to 2.72 for who had transfusion.
      • Our long-term cohort study shows thalassemia is a risk factor for dementia.

      Abstract

      Background

      This study is a nationwide population-based retrospective cohort study to investigate the risk for developing dementia in thalassemia population.

      Methods

      In a longitudinal cohort of 1 million insured people, we identified 871 thalassemia patients who were newly diagnosed between 2000 and 2004 and selected a comparison cohort of 3484 subjects without thalassemia. We analyzed the risks for thalassemia and dementia using Cox proportional hazard regression models to assess the dementia risk in thalassemia patients after adjusting for age, gender, insured amount, urbanization and comorbidities.

      Results

      The overall risks for developing dementia were 1.88-fold (95% CI = 1.10–3.21) in patients with thalassemia compared with the comparison cohort after adjusting for age, sex, insured amount, urbanization and comorbidities. The combined effects measured for patients afflicted with thalassemia and the comorbidities of diabetes, hypertension, CAD, head injury, depression, CKD, or substance-related disorder exhibited a significant association with hyperlipidemia risk compared with that measured for patients without thalassemia and without any counterpart comorbidities. In subgroup analysis, the HRs of dementia increased, from 1.69 (95% CI = 0.93–3.07) for those who had not undergone transfusion to 2.72 (95% CI = 1.09–6.78) for those experienced transfusion compared with the no thalassemia cohort (p for trend < 0.01).

      Conclusion

      Our long-term cohort study result showed that thalassemia should be considered a crucial risk factor for developing dementia.

      Keywords

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