title: Association of traditional Chinese medicine therapy and the risk of dementia in patients with hypertension: a nationwide population-based cohort study.
abstract: BACKGROUND
  Patients with hypertension (HTN) reportedly have a higher risk of developing dementia. However, it remains unclear if use of Traditional Chinese Medicine (TCM), the most common form of complementary and alternative medicine, can help lower the risk of dementia for these patients. So the aim of the study was to investigate the effects of TCM on dementia risk among patients with hypertension.
  
  
  METHODS
  This longitudinal cohort study used the Taiwanese National Health Insurance Research Database (NHIRD) to identify 143,382 newly diagnosed hypertension patients aged 20-90 years who received treatment between 1998 and 2007. Among them, 52,365 (36.52%) had received TCM after the onset of hypertension (TCM users), and the remaining 91,017 patients (63.48%) were designated as a control group (non-TCM users). All enrollees were followed until the end of 2012 to record the incidence of dementia. A Cox proportional hazards regression model was used to compute the hazard ratio (HR) of dementia in patients who received TCM.
  
  
  RESULTS
  During the 15-year follow-up, 3933 TCM users and 10,316 non-TCM users developed dementia, representing an incidence rate of 8.41 and 11.55%, respectively, per 1000 person-years. TCM users had a significantly reduced risk of dementia compared to non-TCM users (adjusted HR = 0.76; 95% confidence interval [CI] = 0.74-0.81). The predominant effect was observed among those treated with TCM longer than 180 days (adjusted HR = 0.65; 95% CI = 0.62-0.69). Among the commonly used TCM products, Tian-Ma-Gou-Teng-Yin, Dan-Shen (Radix Salviae Miltiorrhizae), Chuan-Niu-Xi (Radix Cyathulae), Ge-Gen (Radix Puerariae), Jia-Wei-Xiao-Yao-San, and Jue-Ming-Zi (Semen Cassiae) were significantly associated with a lower risk of dementia.
  
  
  CONCLUSIONS
  Results from this population-based study support the effects of TCM on reducing dementia risk, which may provide a reference for dementia prevention strategies.
authors.affiliation: Department of Chinese Medicine, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, 2 Minsheng Road, Dalin Township, Chiayi, 62247, Taiwan.
authors.forename: Kuen-Hau
authors.initials: KH
authors.lastname: Chen
authors.affiliation: Department of Chinese Medicine, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, 2 Minsheng Road, Dalin Township, Chiayi, 62247, Taiwan.|School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, 701 Jhongyang Road Section 3, Hualien, 97004, Taiwan.|School of Chinese Medicine, China Medical University, Taichung, 40402, Taiwan.
authors.forename: Ming-Hsien
authors.initials: MH
authors.lastname: Yeh
authors.affiliation: Rehabilitation Counseling Program, Portland State University, Portland, OR, 97207-0751, USA.
authors.forename: Hanoch
authors.initials: H
authors.lastname: Livneh
authors.affiliation: Department of Chinese Medicine, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, 2 Minsheng Road, Dalin Township, Chiayi, 62247, Taiwan.
authors.forename: Bor-Chyuan
authors.initials: BC
authors.lastname: Chen
authors.affiliation: School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, 701 Jhongyang Road Section 3, Hualien, 97004, Taiwan.
authors.forename: I-Hsin
authors.initials: IH
authors.lastname: Lin
authors.affiliation: Division of Allergy, Immunology and Rheumatology, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, 2 Minsheng Road, Dalin Township, Chiayi, 62247, Taiwan.|School of Medicine, Tzu Chi University, 701 Jhongyang Road Section 3, Hualien, 97004, Taiwan.
authors.forename: Ming-Chi
authors.initials: MC
authors.lastname: Lu
authors.affiliation: Department of Medical Research, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, 2 Minsheng Road, Dalin Township, Chiayi, 62247, Taiwan. dm732024@tzuchi.com.tw.|Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, 138 Sheng-Li Road, Tainan, 70428, Taiwan. dm732024@tzuchi.com.tw.|Department of Nursing, Tzu Chi University of Science and Technology, 880 Chien-Kuo Road Section 2, Hualien, 97004, Taiwan. dm732024@tzuchi.com.tw.
authors.forename: Tzung-Yi
authors.initials: TY
authors.lastname: Tsai
authors.affiliation: Department of Chinese Medicine, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, 2 Minsheng Road, Dalin Township, Chiayi, 62247, Taiwan. yehcc0530@gmail.com.|School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, 701 Jhongyang Road Section 3, Hualien, 97004, Taiwan. yehcc0530@gmail.com.|School of Chinese Medicine, China Medical University, Taichung, 40402, Taiwan. yehcc0530@gmail.com.
authors.forename: Chia-Chou
authors.initials: CC
authors.lastname: Yeh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003704:Dementia / Q000150:complications / Q000188:drug therapy*; D004365:Drugs, Chinese Herbal / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy*; D008137:Longitudinal Studies; D008297:Male; D008516:Medicine, Chinese Traditional; D008875:Middle Aged; D013624:Taiwan; D055815:Young Adult
chemical_list: D004365:Drugs, Chinese Herbal
keywords: Cohort study; Dementia; Hypertension; Traditional Chinese medicine