Alzheimer's disease in systemic sclerosis patients: A nationwide population-based cohort study

Abdulla Watad, Nicola L. Bragazzi, Shmuel Tiosano, Yarden Yavne, Doron Comaneshter, Arnon D. Cohen, Howard Amital

    Research output: Contribution to journalArticlepeer-review

    7 Scopus citations

    Abstract

    Background: Neurological features are often overlooked in systemic sclerosis (SSc) patients and little is known about the link between dementia and SSc. Objectives: We sought to investigate whether an association exists between Alzheimer's disease (AD) and SSc, as well as assess the impact of a dual diagnosis on mortality rates, by performing an extensive data analysis on a large subject sample. Methods: We utilized the medical database of the Clalit-Health-Services in a case-control study. Patients with SSc were compared with age- and sex-matched controls with regard to the prevalence of AD and its impact on their mortality. Results: Our study included 2,431 SSc patients and 12,377 age- and sex-matched controls. The mean age of the study population was 63.32±18.06 years and the female to male ratio was 4.5:1. 134 (5.5%) cases had AD as a co-morbidity in comparison with 749 (5.9%) of the controls. The mortality rate was 12.5% among controls and 26.2% among SSc cases. On the Cox multivariate survival analysis, diagnosis of SSc and AD demonstrated significant HRs (2.35 (95% CI 2.05-2.69, p < 0.0001) and 2.19 (95% CI 1.94-2.48, p < 0.0001), respectively). SSc patients with AD had a relative risk of death of 2.35 (95% CI: 1.44-3.83) in comparison with SSc patients without AD. Conclusion: AD is a predictor of death in SSc and therefore preemptive screening may be warranted. Further studies are needed to evaluate whether improvements in the medical regimen for SSc may lead to a reduction in AD development and possibly to increased survival as well.

    Original languageEnglish
    Pages (from-to)117-124
    Number of pages8
    JournalJournal of Alzheimer's Disease
    Volume65
    Issue number1
    DOIs
    StatePublished - 1 Jan 2018

    Keywords

    • Alzheimer's disease
    • autoimmune diseases
    • dementia
    • scleroderma
    • systemic sclerosis

    ASJC Scopus subject areas

    • Neuroscience (all)
    • Clinical Psychology
    • Geriatrics and Gerontology
    • Psychiatry and Mental health

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