title: Diverticular disease and additional comorbidities associated with increased risk of dementia.
abstract: OBJECTIVE
  Colonic diverticular disease may cause a chronic systemic effect, but its role in the development of dementia remains unclear. The purpose of this study was to investigate the potential increased risk for dementia in colonic diverticular disease.
  
  
  METHODS
  We conducted a population-based cohort study using data from Taiwan's National Health Insurance Research Database. A total of 66 377 sex-matched, age-matched, and index year-matched (1:4) pairs of patients with colonic diverticular disease and 265 508 patients without colonic diverticular disease, who served as controls, were selected from all potential participants aged 20 years or older in the database. Each subject was individually tracked from 2000 to 2011 to identify incident cases of dementia. Cox proportional hazards regression was employed to calculate the hazard ratios and 95% confidence intervals for the association between colonic diverticular disease and dementia.
  
  
  RESULTS
  There were 1057 dementia cases in the diverticular disease cohort during the follow-up period of 315 171 person-years; the overall incidence rate of dementia differed from that of the control group (3.35 vs 2.43 per 1000 person-years, P < 0.001). The adjusted hazard ratio for dementia was 1.24 (95% confidence interval 1.15-1.33) for diverticular disease patients after adjusting for age, sex, and comorbidities.
  
  
  CONCLUSIONS
  Colonic diverticular disease may be associated with increased risk for dementia.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.|National Yang-Ming University, Taipei, Taiwan.
authors.forename: Yen-Chun
authors.initials: YC
authors.lastname: Peng
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: Division of Gastroenterology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.|National Yang-Ming University, Taipei, Taiwan.
authors.forename: Hong-Zen
authors.initials: HZ
authors.lastname: Yeh
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.|National Yang-Ming University, Taipei, Taiwan.
authors.forename: Chun-Fang
authors.initials: CF
authors.lastname: Tung
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Chi-Sen
authors.initials: CS
authors.lastname: Chang
authors.affiliation: Graduate Institute of Clinical Medical Science and 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; D017677:Age Distribution; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D016208:Databases, Factual; D003704:Dementia / Q000453:epidemiology* / Q000209:etiology; D043963:Diverticulosis, Colonic / Q000150:complications / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012307:Risk Factors; D017678:Sex Distribution; D013624:Taiwan / Q000453:epidemiology
keywords: colonic diverticular disease; dementia; population-based cohort study.