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Abstract
Objectives A nationwide cohort study on the risk of dementia onset after first diagnosis of Parkinson’s disease (PD) is lacking. This study aims to assess 11 years of incidence and the HRs for developing dementia in patients with PD compared with matched controls.
Design A population-based cohort study.
Setting National Health Insurance database in Taiwan.
Participants A total of 5932 patients with PD were identified, and 29 645 age-matched, sex-matched and index year-matched PD-free individuals were randomly selected.
Outcome measures All subjects were linked to the claim data to identify the first diagnosis of dementia. The Poisson assumption was used to estimate the incidence rate. Cause-specific hazards models with a partitioning of time at 1 year to account for proportionality were used to estimate the risk of dementia onset.
Results The median duration from the first diagnosis of PD to the development of dementia was 9.02 years. In the first partition (≦ 1 year), the incidence of dementia in the PD and control groups was 114.49 and 9.76 per 1000 person-years, respectively, with an adjusted HR of 6.43 (95% CI 5.46 to 7.57). In the second partition (>1 year), the incidence of dementia in the PD and control groups was 30.99 and 10.83 per 1000 person-years, with an adjusted HR of 2.42 (95% CI 2.23 to 2.61). Notably, in the second partition, both men and women aged <70 years had the highest HR (3.82, 95% CI 2.79 to 5.22 and 4.27, 95% CI 3.25 to 5.63, respectively).
Conclusions This study noted an increased risk of dementia after a diagnosis of PD. The magnitude of effect estimation was higher in men in the first partition but was similar in both genders in the second partition. PD patients aged <70 years have the highest risk of dementia in any given partition time.
- retrospective cohort study
- parkinson’s disease
- dementia
- competing risk
- epidemiology
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Footnotes
C-YL and SCH contributed equally.
Contributors C-CL analysed the data and wrote the draft of the manuscript. YS and P-CL provided further data analyses and interpretation. C-YL and SCH advised the study and revised the manuscript. All authors have approved the final version of the manuscript.
Funding This study was supported by a grant from Taiwan Ministry of Science and Technology (MOST 106-2314-B-227-010).
Disclaimer The interpretation and conclusions contained herein do not represent those of the Bureau of National Health Insurance, Ministry of Health and Welfare, or National Health Research Institutes.
Competing interests None declared.
Ethics approval A full review by the institutional review board was not required because the encryption of the identification numbers makes it impossible to identify individuals. Access to the National Health Insurance Research Database datasets is approved by the National Health Research Institutes Review Committee.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement We, as the authors of this original research article, state that there is no additional, unpublished data available from this study. Raw data sharing from National Health Insurance Research Database is prohibited according to the National Health Research Institutes policies in Taiwan.
Patient consent for publication Not required.