Alzheimer incidence and prevalence with and without asthma: A Medicare cohort study.

Autor: Bartels CM; Rheumatology Division, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wis; Center for Health Disparities Research, University of Wisconsin School of Medicine and Public Health, Madison, Wis. Electronic address: cb4@medicine.wisc.edu., Chen Y; Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, Wis., Powell WR; Center for Health Disparities Research, University of Wisconsin School of Medicine and Public Health, Madison, Wis; Geriatrics Division, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wis., Rosenkranz MA; Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, Wis; Center for Healthy Minds, University of Wisconsin-Madison, University of Wisconsin School of Medicine and Public Health, Madison, Wis., Bendlin BB; Center for Health Disparities Research, University of Wisconsin School of Medicine and Public Health, Madison, Wis; Geriatrics Division, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wis., Kramer J; Center for Health Disparities Research, University of Wisconsin School of Medicine and Public Health, Madison, Wis., Busse WW; Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wis., Kind A; Center for Health Disparities Research, University of Wisconsin School of Medicine and Public Health, Madison, Wis; Geriatrics Division, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wis.
Jazyk: angličtina
Zdroj: The Journal of allergy and clinical immunology [J Allergy Clin Immunol] 2024 Aug; Vol. 154 (2), pp. 498-502.e1. Date of Electronic Publication: 2024 Apr 24.
DOI: 10.1016/j.jaci.2024.04.008
Abstrakt: Background: International data suggest that asthma, like other inflammatory diseases, might increase Alzheimer disease (AD) risk.
Objective: We sought to explore risk pathways and future mitigation strategies by comparing diagnostic claims-based AD incidence and prevalence among US patients with asthma with those without asthma.
Methods: This cohort study included a national Medicare 20% random sample (2013-2015). Adult patients with asthma with more than 12 months continuous Medicare were compared with subjects without asthma overall and as matched. Asthma was defined by 1 inpatient or 2 outpatient codes for asthma. The main outcomes were 2-year incident or prevalent AD defined by International Classification of Diseases, Ninth Revision code 331.0 or Tenth Revision code G30.0, G30.1, G30.8, or G30.9.
Results: Among 5,460,732 total beneficiaries, 678,730 patients were identified with baseline asthma and more often identified as Black or Hispanic, were Medicaid eligible, or resided in a highly disadvantaged neighborhood than those without asthma. Two-year incidence of AD was 1.4% with asthma versus 1.1% without asthma; prevalence was 7.8% versus 5.4% (both P ≤ .001). Per 100,000 patients over 2 years, 303 more incident AD diagnoses occurred in those with asthma, with 2,425 more prevalent cases (P < .001). Multivariable models showed that asthma had greater odds of 2-year AD incidence (adjusted odds ratio, 1.33 [95% CI, 1.29-1.36]; matched 1.2 [95% CI, 1.17-1.24]) and prevalence (adjusted odds ratio, 1.48 [95% CI, 1.47-1.50]; matched 1.25 [95% CI, 1.22-1.27]).
Conclusions: Asthma was associated with 20% to 33% increased 2-year incidence and 25% to 48% increased prevalence of claims-based AD in this nationally representative US sample. Future research should investigate risk pathways of underlying comorbidities and social determinants as well as whether there are potential asthma treatments that may preserve brain health.
Competing Interests: Disclosure statement This work was supported by the National Institutes of Health (grant nos. R01HL123384 [to W.W.B.] and R01MD010243 [to A.K.]) and the University of Wisconsin School of Medicine and Public Health Department of Medicine’s Cultivating Multidisciplinary Science Award (ID no. 233 AAH5488 [to W.W.B.]). The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. Disclosure of potential conflict of interest: C. M. Bartels reported grant funding from Pfizer Independent Grants for Learning and Change, outside the submitted work. W. W. Busse reported consultant and speaker fees from GlaxoSmithKline, Sanofi/Genzyme, and Regeneron, outside the submitted work. The rest of the authors declare that they have no relevant conflicts of interest.
(Copyright © 2024 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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