Chun‐Hung Tseng

< 0.001). To conclude, based on these data, epileptic individuals ≥50 years were at a greater risk of developing dementia than people who do not have epilepsy, which indicates that a diagnosis of epilepsy presents a greater risk for the development of dementia.

// Chung-Hsing Chou 1, 2 , Jiunn-Tay Lee 1, 2 , Chun-Chieh Lin 1 , Yueh-Feng Sung 1 , Che-Chen Lin 3 , Chih-Hsin Muo 3 , Fu-Chi Yang 1 , Chi-Pang Wen 4 , I-Kuan Wang 5, 6, 7 , Chia-Hung Kao 5, 8 , Chung Y. Hsu 5 and Chun-Hung Tseng 9 1 Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China 2 Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, Republic of China 3 Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan, Republic of China 4 Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan, Republic of China 5 Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan, Republic of China 6 Department of Internal Medicine, College of Medicine, China Medical University, Taichung, Taiwan, Republic of China 7 Division of Kidney Disease, China Medical University Hospital, Taichung, Taiwan, Republic of China 8 Department of Nuclear Medicine, PET Center, China Medical University Hospital, Taichung, Taiwan, Republic of China 9 Department of Neurology, China Medical University Hospital, Taichung, Taiwan, Republic of China Correspondence to: Jiunn-Tay Lee, email: jiunntay@gmail.com Keywords: septicemia, infection, dementia, Alzheimer&rsquo;s disease, non-Alzheimer dementias Received: May 17, 2017&emsp;&emsp;&emsp;&emsp; Accepted: August 04, 2017&emsp;&emsp;&emsp;&emsp; Published: September 15, 2017 ABSTRACT Background: Systemic infection has been linked to cognitive impairment. We hypothesized that patients with septicemia are predisposed to increased risks for developing dementia in a long-term setting. Methods: This observational, retrospective, longitudinal, nation-wide population-based study was conducted using the data deduced from Longitudinal Health Insurance Database (LHID) in Taiwan. All patients with septicemia hospitalized for the first time from 2001 to 2011 without prior dementia were included. The development of Alzheimer&rsquo;s disease (AD) or non-Alzheimer dementias (NAD) in relation to the development of septicemia for each patient was recorded. An age- and sex-matched cohort without septicemia and without prior dementia served as the control. Septicemia, dementia, and other confounding factors were defined according to International Classification of Diseases Clinical Modification Codes. Cox proportional-hazards regressions were utilized to analyze adjusted hazard ratios. Results: Patients with septicemia had a higher risk for developing dementia based on hazard ratios (HRs) ( p &lt;0.001). Patients with septicemia in the younger age groups had a greater dementia risk ( p &lt;0.01). Septicemia was associated with subsequent NAD ( p &lt;0.001), whereas the increased risk of AD was statistically insignificant ( p &gt;0.05). Furthermore, higher severity of septicemia was associated with increased risk of developing dementia. Conclusions: Our findings suggest that septicemia is associated with an increased risk in developing NAD but not AD. A likely causal role of septicemia in increasing the risk of NAD is suggested, according to the findings that patients with higher severity of septicemia carried greater risk of sustaining dementia.

Inflammation and infection have been noted to increase stroke risk. However, the association between septicaemia and increased risk of stroke remains unclear. This population-based cohort study, using a National Health Insurance database, aimed to investigate whether patients with septicaemia are predisposed to increased stroke risk. The study included all patients hospitalised for septicaemia for the first time between 2000 and 2003 without prior stroke. Patients were followed until the end of 2010 to evaluate incidence of stroke. An age-, gender- and co-morbidities-matched cohort without prior stroke served as the control. Cox's proportional hazards regressions were used to assess differences in stroke risk between groups. Based on hazard ratios (HRs), patients with septicaemia had greater stroke risk, especially in the younger age groups (age <45: HR = 4.16, 95% CI: 2.39-7.24, p<0.001; age 45-64: HR = 1.76, 95% CI: 1.41-2.19, p<0.001; age ≥ 65: HR = 1.05, 95% CI: 0.91-1.22, p>0.05). Haemorrhagic stroke was the dominant type (ischaemic stroke: HR = 1.20, 95% CI: 1.06-1.37, p<0.01; haemorrhagic stroke: HR = 1.82, 95% CI: 1.35-2.46, p<0.001) and patients without co-morbidities were at slightly higher risk (without co-morbidities: HR = 1.49, 95% CI: 1.02-2.17, p<0.05; with co-morbidities: HR = 1.24, 95% CI: 1.10-1.41, p<0.001). The impact of septicaemia on stroke risk was highest within 6 months of the event and gradually declined over time. Our results suggest that septicaemia is associated with an increase in stroke risk, which is greatest in haemorrhagic stroke. Closer attention to patients with history of septicaemia may be warranted for stroke preventive measures, especially for younger patients without co-morbidities.