title: Irritable Bowel Syndrome Is Associated with an Increased Risk of Dementia: A Nationwide Population-Based Study.
abstract: OBJECTIVE
  Abnormal interaction in the brain-gut axis has emerged as one of the relevant pathophysiological mechanisms for the development of irritable bowel syndrome (IBS). Moreover, the brain-gut axis has recently been demonstrated to be crucial for the maintenance of cognitive performance. Therefore, we assessed the risk of dementia following diagnosis of IBS.
  
  
  METHODS
  Using the Taiwan National Health Insurance Research Database (NHIRD) to obtain medical claims data from 2000 to 2011, we employed a random sampling method to enroll32 298 adult patients with IBS and frequency-matched them according to sex, age, and baseline year with 129 192 patients without IBS.
  
  
  RESULTS
  The patients with IBS exhibited an increased risk of dementia [adjusted hazard ratio (aHR) = 1.26, 95% confidence interval (CI) = 1.17-1.35]after adjustment for age, sex, diabetes, hypertension, stroke, coronary artery disease (CAD), head injury, depression, and epilepsy, and the overall incidence of dementia for the cohorts with and without IBS was 4.86 and 3.41 per 1000 person-years, respectively. IBS was associated with an increased risk of dementia in patients older than 50 years in both male and female, and in those with comorbidity or without comorbidity. After adjustment for age, sex, and comorbidity, patients with IBS were also more likely to develop either non- Alzheimer's disease (AD) dementia (aHR = 1.24, 95% CI = 1.15-1.33) or AD (aHR = 1.76, 95% CI = 1.28-2.43).
  
  
  CONCLUSIONS
  IBS is associated with an increased risk of dementia, and this effect is obvious only in patients who are ≥50 years old.
authors.affiliation: Digestive Disease Center, Show-Chwan Memorial Hospital, Changhua, Taiwan.|Hungkuang University, Taichung, Taiwan.|Meiho University of Technology, Pingtung, Taiwan.
authors.forename: Chien-Hua
authors.initials: CH
authors.lastname: Chen
authors.affiliation: Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.|College of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Cheng-Li
authors.initials: CL
authors.lastname: Lin
authors.affiliation: Graduate Institute of Clinical Medical Science, School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.|Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Chia-Hung
authors.initials: CH
authors.lastname: Kao
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D006259:Craniocerebral Trauma / Q000453:epidemiology; D003704:Dementia / Q000453:epidemiology*; D003863:Depression / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology; D004827:Epilepsy / Q000453:epidemiology; D005260:Female; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000453:epidemiology* / Q000523:psychology; D008297:Male; D064307:Microbiota; D008875:Middle Aged; D016016:Proportional Hazards Models; D012306:Risk; D012307:Risk Factors; D012494:Sampling Studies; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult