Abstract
PurposeAbnormal interaction in the brain–gut axis has emerged as one of the relevant pathophysiological mechanisms for the development of irritable bowel syndrome (IBS). Moreover, the brain–gut axis has recently been demonstrated to be crucial for the maintenance of cognitive performance. Therefore, we assessed the risk of dementia following diagnosis of IBS.MethodsUsing the Taiwan National Health Insurance Research Database (NHIRD) to obtain medical claims data from 2000 to 2011, we employed a random sampling method to enroll32 298 adult patients with IBS and frequency-matched them according to sex, age, and baseline year with 129 192 patients without IBS.ResultsThe patients with IBS exhibited an increased risk of dementia [adjusted hazard ratio (aHR) = 1.26, 95% confidence interval (CI) = 1.17–1.35]after adjustment for age, sex, diabetes, hypertension, stroke, coronary artery disease (CAD), head injury, depression, and epilepsy, and the overall incidence of dementia for the cohorts with and without IBS was 4.86 and 3.41 per 1000 person-years, respectively. IBS was associated with an increased risk of dementia in patients older than 50 years in both male and female, and in those with comorbidity or without comorbidity. After adjustment for age, sex, and comorbidity, patients with IBS were also more likely to develop either non- Alzheimer’s disease (AD) dementia (aHR = 1.24, 95% CI = 1.15–1.33) or AD (aHR = 1.76, 95% CI = 1.28–2.43).ConclusionsIBS is associated with an increased risk of dementia, and this effect is obvious only in patients who are ≥50 years old.
Highlights
Irritable bowel syndrome (IBS) is characterized by recurrent abdominal pain or discomfort with altered visceral hypersensitivity or gastrointestinal (GI) motility
The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript
No additional external funding received for this study
Summary
Irritable bowel syndrome (IBS) is characterized by recurrent abdominal pain or discomfort with altered visceral hypersensitivity or gastrointestinal (GI) motility. Evidence supports that a diagnosis of IBS can be confidently made for the patients fitting the symptoms-based criteria and having no concerning features for organic diseases, including symptom onset after age 50, severe or progressively worsening symptoms, unexplained weight loss, nocturnal diarrhea, GI bleeding, unexplained iron-deficiency anemia, and family history of colonic cancer, celiac disease, or inflammatory bowel disease [1]. Most IBS patients will have a negative evaluation result if they have no concerning features. The GI tract can modulate brain function reciprocally through the same mechanism [8, 9]
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