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Dementia and vagotomy in Taiwan: a population-based cohort study
  1. Shih-Yi Lin1,2,
  2. Cheng-Li Lin3,4,
  3. I-Kuan Wang1,2,
  4. Cheng-Chieh Lin1,5,
  5. Chih-Hsueh Lin1,5,
  6. Wu-Huei Hsu1,6,
  7. Chia-Hung Kao1,7,8
  1. 1 Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taichung, Taiwan
  2. 2 Division of Nephrology and Kidney Institute, China Medical University Hospital, Taichung, Taiwan
  3. 3 Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
  4. 4 College of Medicine, China Medical University, Taichung, Taiwan
  5. 5 Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
  6. 6 Division of Pulmonary and Critical Care Medicine, China Medical University Hospital and China Medical University, Taichung, Taiwan
  7. 7 Department of Nuclear Medicine, China Medical University Hospital, Taichung, Taiwan
  8. 8 Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan
  1. Correspondence to Dr Chia-Hung Kao; d10040{at}mail.cmuh.org.tw

Abstract

Objective Truncal vagotomy is associated with a decreased risk of subsequent Parkinson disease (PD), although the effect of vagotomy on dementia is unclear. In response, we investigated the risk of dementia in patients who underwent vagotomy.

Setting Population-based cohort study.

Participants A total of 155 944 patients who underwent vagotomy (vagotomy cohort) and 155 944 age-matched, sex-matched and comorbidity-matched controls (non-vagotomy cohort) were identified between 2000 and 2011.

Primary and secondary outcome measures All patient data were tracked until the diagnosis of dementia, death or the end of 2011. The cumulative incidence of subsequent dementia and HRs were calculated.

Results The mean ages of the study patients in the vagotomy and non-vagotomy cohorts were 56.6±17.4 and 56.7±17.3 years, respectively. The overall incidence density rate for dementia was similar in the vagotomy and non-vagotomy cohorts (2.43 and 2.84 per 1000 person-years, respectively). After adjustment for age, sex and comorbidities such as diabetes, hypertension, hyperlipidaemia, stroke, depression, coronary artery disease and PD, the patients in the vagotomy cohort were determined to not be at a higher risk of dementia than those in the non-vagotomy cohort (adjusted HR=1.09, 95% CI 0.87 to 1.36). Moreover, the patients who underwent truncal vagotomy were not associated with risk of dementia (adjusted HR=1.04, 95% CI 0.87 to 1.25), compared with the patients who did not undergo vagotomy.

Conclusion Vagotomy, either truncal or selective, is not associated with risk of dementia.

  • parkinson disease
  • dementia
  • vagotomy
  • cohort study

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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Footnotes

  • Contributors Conceptualisation: S-YL, C-HK. Methodology: C-LL, C-HK. Software: C-LL, C-HK. Validation: S-YL, C-LL, I-KW, C-CL, C-HL, W-HH, C-HK. Formal analysis: S-YL, C-LL, I-KW, C-CL, C-HL, W-HH, C-HK. Investigation: C-LL, C-HK. Resources: C-LL, C-HK. Data curation: S-YL, C-LL, I-KW, C-CL, C-HL, W-HH, C-HK. Writing (original draft preparation): S-YL, C-LL, I-KW, C-CL, C-HL, W-HH, C-HK. Writing (review and editing): S-YL, C-LL, I-KW, C-CL, C-HL, W-HH, C-HK. Visualisation: S-YL, C-LL, I-KW, C-CL, C-HL, W-HH, C-HK. Supervision: C-HK. Project administration: C-HK. Funding acquisition: C-HK.

  • Funding This work was supported by grants from the Ministry of Health and Welfare, Taiwan (MOHW107-TDU-B-212-123004), China Medical University Hospital; Academia Sinica Stroke Biosignature Project (BM10701010021); MOST Clinical Trial Consortium for Stroke (MOST 106-2321-B-039-005-); Tseng-Lien Lin Foundation, Taichung, Taiwan;and Katsuzo and Kiyo Aoshima Memorial Funds, Japan. No additional external funding received for this study.

  • Disclaimer The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

  • Competing interests None declared.

  • Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.

  • Ethics approval The Research Ethics Committee of China Medical University and Hospital in Taiwan approved the study (CMUH104-REC2-115-CR2).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The data set used in this study is held by the Taiwan Ministry of Health and Welfare (MOHW). The Ministry of Health and Welfare must approve our application to access this data. Any researcher interested in accessing this data set can submit an application form to the Ministry of Health and Welfare requesting access. Please contact the staff of MOHW (email: stcarolwu@mohw.gov.tw) for further assistance. Taiwan Ministry of Health and Welfare address: No 488, Sec 6, Zhongxiao E Rd, Nangang Dist, Taipei City 115, Taiwan (ROC). Phone: +886-2-8590-6848. All relevant data are within the paper.

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