Background And Objective: Preliminary evidence suggests a possible preventive effect of tumor necrosis factor-α inhibitors (TNFi) on incident dementia. The objective of the analysis was to investigate the association between TNFi and the risk of incident dementia in a population undergoing treatment for rheumatological disorders.
Methods: We followed patients aged ≥ 65 years with dementia and rheumatological conditions in two cohort studies, DANBIO (N = 21,538), a Danish clinical database, and AOK PLUS (N = 7112), a German health insurance database. We defined incident dementia using diagnostic codes and/or medication use and used Cox regression to compare the associations of TNFi with other rheumatological therapies on the risk of dementia. To ensure that the patients were receiving long-term medication, we included patients with rheumatic diseases and systemic therapies.
Results: We observed similar trends towards a lower risk of dementia associated with TNFi versus other anti-inflammatory agents in both cohorts (hazard ratios were 0.92 [95% confidence interval 0.76, 1.10] in DANBIO and 0.89 [95% confidence interval 0.63, 1.24] in AOK PLUS, respectively).
Conclusions: Tumor necrosis factor-α inhibitors may decrease the risk of incident dementia although the association did not reach statistical significance in this analysis. Further research, ideally with randomization, is needed to gauge the potential of repurposing TNFi for dementia prevention and/or treatment.
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http://dx.doi.org/10.1007/s40266-024-01112-1 | DOI Listing |
Increasing evidence suggests the involvement of metabolic alterations in neurological disorders, including Alzheimer's disease (AD), and highlights the significance of the peripheral metabolome, influenced by genetic factors and modifiable environmental exposures, for brain health. In this study, we examined 1,387 metabolites in plasma samples from 1,082 dementia-free middle-aged participants of the population-based Rotterdam Study. We assessed the relation of metabolites with general cognition (G-factor) and magnetic resonance imaging (MRI) markers using linear regression and estimated the variance of these metabolites explained by genes, gut microbiome, lifestyle factors, common clinical comorbidities, and medication using gradient boosting decision tree analysis.
View Article and Find Full Text PDFBackground: The long-term impact of opioid use disorder (OUD) on brain health has been little explored although of potentially high public health importance.
Objectives: To investigate the potential causal impact of OUD on later life brain health outcomes, including dementia, stroke and brain structure.
Methods: Observational and Mendelian randomization (MR) analyses were conducted.
Am J Epidemiol
January 2025
Department of Social Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg.
Algorithmic estimations of dementia status are widely used in public health and epidemiological research, however, inadequate algorithm performance across racial/ethnic groups has been a barrier. We present improvements in the accuracy of group-specific "probable dementia" estimation using a transfer learning approach. Transfer learning involves combining models trained on a large "source" dataset with imprecise outcome assessments, alongside models trained on a smaller "target" dataset with high-quality outcome assessments.
View Article and Find Full Text PDFEur Heart J Qual Care Clin Outcomes
January 2025
Division of Cardiology, Department of Medicine, University of California-San Francisco, San Francisco, CA, USA.
Background: Recommendations on atrial fibrillation (AF) screening by various scientific societies are inconsistent due to uncertainty about its benefit. This study aimed to summarize data from randomized controlled trials (RCTs) on the impact of AF screening on thromboembolism, major bleeding, and mortality.
Methods: We searched PubMed/MEDLINE and Embase to identify studies providing relevant data through September 05, 2024.
J Neurol Neurosurg Psychiatry
January 2025
Department of Psychology, Nanyang Technological University, Singapore
Background: White matter hyperintensities (WMH) have been implicated in the pathogenesis of neuropsychiatric symptoms of dementia but the functional significance of WMH in specific white matter (WM) tracts is unclear. We investigate whether WMH burden within major WM fibre classes and individual WM tracts are differentially associated with different neuropsychiatric syndromes in a large multicentre study.
Method: Neuroimaging and neuropsychiatric data of seven memory clinic cohorts through the Meta VCI Map consortium were harmonised.
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