Cognitive enhancers associated with decreased risk of injury in patients with dementia: a nationwide cohort study in Taiwan

This study aimed to investigate the associations among dementia, psychotropic medications and the risk of overall injuries. In this nationwide matched cohort study, a total of 144 008 enrolled patients ≥age of 50, with 36 002 study subjects who suffered from dementia and 108 006 controls matched for sex and age, from the Inpatient Dataset, for the period 2000–2010 in Taiwan were selected from the National Health Insurance Research Database, according to International Classification of Diseases, 9th Revision, Clinical Modification. When adjusting for the confounding factors, a Cox proportional hazards analysis was used to compare the risk of developing psychiatric disorders during the 10 years of follow-up. Of the study subjects, 6701 (18.61%) suffered injury when compared with 20 919 (19.37%) in the control group. The Cox regression analysis revealed that the study subjects were more likely to develop an injury (HR: 2.294, 95% CI=2.229 to 2.361, P<0.001) after adjusting for sex, age, monthly income, urbanization level, geographic region, and comorbidities. Psychotropic medications in the subjects with dementia were associated with the risk of injury (adjusted HR=0.217, 95% CI: 0.206 to 0.228, P<0.001). Cognitive enhancers, including acetylcholinesterase inhibitors and memantine, were associated with the risk of injury in the study subjects after being adjusted for all comorbidities and medications (adjusted HR=0.712(95% CI=0.512 to 0.925, P<0.01)). In conclusion, patients who suffered dementia had a higher risk of developing injury, and the cognitive enhancers were associated with the decreased risk of injury.

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Post-Traumatic Stress Disorder and the Risk of Erectile Dysfunction: A Nationwide Cohort Study in Taiwan

10.21203/rs.3.rs-370664/v1 ◽

2021 ◽

Author(s):

Sheng-Chiang Wang ◽

Wu-Chien Chien ◽

Chi-Hsiang Chung ◽

Nian-Sheng Tzeng ◽

Yia-Ping Liu

Keyword(s):

Posttraumatic Stress Disorder ◽

Cohort Study ◽

Erectile Dysfunction ◽

Posttraumatic Stress ◽

Stress Disorder ◽

Cox Regression ◽

Geographic Region ◽

Research Database ◽

Post Traumatic Stress ◽

Cox Regression Analysis

Abstract BACKGROUND: This study aimed to investigate the association between posttraumatic stress disorder and the risk of developing erectile dysfunction.METHODS: In this population-based, retrospective cohort study, we used Taiwan’s National Health Insurance Research Database to analyze the patients who were newly diagnosed with posttraumatic stress disorder (PTSD) between 2000 and 2013, with a 1:3 ratio by age, and index year matched in the non-PTSD comparison group, for the risk of erectile dysfunction. RESULTS: In total, five out of 1,079 patients with PTSD developed erectile dysfunction, and three out of 3,237 patients in the non-PTSD group (47.58 vs 9.03 per 100,000 per person-year) developed erectile dysfunction. The Kaplan-Meier analysis showed that the PTSD cohort had a significantly higher risk of erectile dysfunction (log-rank, p<0.001). The Cox regression analysis revealed that the study subjects were more likely to develop an injury (HR: 12.898, 95% CI=2.453- 67.811, p=0.003) after adjusting for age, monthly income, urbanization level, geographic region, and comorbidities. Psychotropic medications in the patients with PTSD were not associated with the risk of erectile dysfunction.CONCLUSIONS: Patients who suffered PTSD had a higher risk of developing erectile dysfunction.

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Chronic Periodontitis Is Associated with the Risk of Bipolar Disorder: A Population-Based Cohort Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17103466 ◽

2020 ◽

Vol 17 (10) ◽

pp. 3466

Author(s):

Yung-Kai Huang ◽

Yu-Hsun Wang ◽

Yu-Chao Chang

Keyword(s):

Bipolar Disorder ◽

Cohort Study ◽

Chronic Periodontitis ◽

Cox Regression ◽

Population Based ◽

Cox Proportional Hazards ◽

Etiologic Factor ◽

Research Database ◽

Cox Regression Analysis ◽

Increased Risk

Bipolar disorder (BD) is a psychiatric mood disturbance manifested by manic, hypomanic, or major depressive periods. Chronic inflammation was evidenced as an important etiologic factor of BD. Chronic periodontitis (CP) is an inflammatory disease triggered by bacterial products, leading to the destruction of periodontium. The relationship between BD and CP is of interest to investigate. Therefore, a nationwide population-based cohort study was used to investigate the risk of BD and CP exposure from 2001 to 2012. We identified 61,608 patients with CP from the Taiwanese National Health Insurance Research Database (NHIRD). The 123,216 controls were randomly captured and matched by age, sex, index year, and co-morbidities. The association between CP exposure and BD risk was examined by Cox proportional hazards regression models. In this study, 61,608 CP patients and 123,216 controls were followed up for 7.45 and 7.36 years, respectively. In total, 138 BD patients were identified in the CP cohort and 187 BD cases were found in the non-CP cohort. The incidence rate of BD was significantly higher in the CP cohort than in the non-CP cohort (adjusted HR: 1.46, 95% CI: 1.17–1.81) according to the multivariate Cox regression analysis. Females had a 1.47-fold increased risk (95% CI: 1.16–1.86) for BD compared to males. Taken together, CP may be associated with an increased risk of subsequent BD in Taiwan.

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Posttraumatic stress disorder and the risk of erectile dysfunction: a nationwide cohort study in Taiwan

Annals of General Psychiatry ◽

10.1186/s12991-021-00368-w ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Sheng-Chiang Wang ◽

Wu-Chien Chien ◽

Chi-Hsiang Chung ◽

Nian-Sheng Tzeng ◽

Yia-Ping Liu

Keyword(s):

Posttraumatic Stress Disorder ◽

Cohort Study ◽

Erectile Dysfunction ◽

Posttraumatic Stress ◽

Stress Disorder ◽

Cox Regression ◽

Geographic Region ◽

Research Database ◽

Cox Regression Analysis ◽

Ptsd Group

Abstract Background This study aimed to investigate the association between posttraumatic stress disorder and the risk of developing erectile dysfunction. Methods In this population-based retrospective cohort study, we used Taiwan’s National Health Insurance Research Database to analyze patients who were newly diagnosed with posttraumatic stress disorder (PTSD) between 2000 and 2013, with a 1:3 ratio by age and index year matched with patients in a non-PTSD comparison group, for the risk of erectile dysfunction. Results In total, 5 out of 1079 patients in the PTSD group developed erectile dysfunction, and 3 out of 3237 patients in the non-PTSD group (47.58 vs. 9.03 per 100,000 per person-year) developed erectile dysfunction. The Kaplan–Meier analysis showed that the PTSD cohort had a significantly higher risk of erectile dysfunction (log-rank, p < 0.001). The Cox regression analysis revealed that the study subjects were more likely to develop an injury (hazard ratio: 12.898, 95% confidence intervals = 2.453–67.811, p = 0.003) after adjusting for age, monthly income, urbanization level, geographic region, and comorbidities. Psychotropic medications used by the patients with PTSD were not associated with the risk of erectile dysfunction. Conclusions Patients who suffered from PTSD had a higher risk of developing erectile dysfunction.

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The incidence of mental disorder increases after hip fracture in older people: a nationwide cohort study

BMC Geriatrics ◽

10.1186/s12877-021-02195-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ling-Yin Kuo ◽

Po-Ting Hsu ◽

Wen-Tien Wu ◽

Ru-Ping Lee ◽

Jen-Hung Wang ◽

...

Keyword(s):

Cohort Study ◽

Hip Fracture ◽

Geriatric Patients ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Control Group ◽

Research Database ◽

Fracture Group ◽

Related Risk ◽

And Control

Abstract Background People living with dementia seem to be more likely to experience delirium following hip fracture. The association between mental disorders (MD) and hip fracture remains controversial. We conducted a nationwide study to examine the prevalence of MD in geriatric patients with hip fractures undergoing surgery and conducted a related risk factor analysis. Material and methods This retrospective cohort study used data from Taiwan’s National Health Insurance Research Database between 2000 and 2012 and focused on people who were older than 60 years. Patients with hip fracture undergoing surgical intervention and without hip fracture were matched at a ratio of 1:1 for age, sex, comorbidities, and index year. The incidence and hazard ratios of age, sex, and multiple comorbidities related to MD and its subgroups were calculated using Cox proportional hazards regression models. Results A total of 1408 patients in the hip fracture group and a total of 1408 patients in the control group (no fracture) were included. The overall incidence of MD for the hip fracture and control groups per 100 person-years were 0.8 and 0.5, respectively. Among MD, the incidences of transient MD, depression, and dementia were significantly higher in the hip fracture group than in the control group. Conclusions The prevalence of newly developed MD, especially transient MD, depression, and dementia, was higher in the geriatric patients with hip fracture undergoing surgery than that in the control group. Prompt and aggressive prevention protocols and persistent follow-up of MD development is highly necessary in this aged society.

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The Risk of Mortality among Psoriatic Patients with Varying Severity: A Nationwide Population-Based Cohort Study in Taiwan

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph15122622 ◽

2018 ◽

Vol 15 (12) ◽

pp. 2622 ◽

Cited By ~ 5

Author(s):

Ying-Xiu Dai ◽

Ming-Chun Hsu ◽

Hsiao-Yun Hu ◽

Yun-Ting Chang ◽

Tzeng-Ji Chen ◽

...

Keyword(s):

Cohort Study ◽

Psoriatic Arthritis ◽

Mortality Risk ◽

Psoriasis Patient ◽

Population Based ◽

Cox Proportional Hazards ◽

Severe Psoriasis ◽

Control Group ◽

Research Database ◽

Control Subjects

Background: Previous studies showed conflicting results regarding the mortality risk in psoriasis patients with respect to disease severity and presence of psoriatic arthritis. This study aimed to determine the mortality risk in patients with mild and severe psoriasis and patients with psoriatic arthritis (PsA). Methods: A nationwide population-based cohort study was conducted based on data from the Taiwan National Health Insurance Research Database between 2002 and 2012. Incident psoriasis subjects were classified into two groups: psoriasis without arthritis and psoriasis with arthritis. Patients who had received systemic therapy and/or phototherapy were classified as having severe psoriasis; otherwise, patients were classified as having mild psoriasis. Control subjects without psoriasis were selected to match each psoriasis patient from the database within the same observational period. Cox proportional hazards analysis was used to compare the hazard ratio (HR) of time to death. Results: A total of 106,701 patients with psoriasis were included in this study. After controlling for demographics and comorbidities, psoriasis patients had a higher mortality risk compared with the control group (HR 1.41; 95% confidence interval (CI) 1.36 to 1.46). Compared with psoriasis alone, the mortality risk was not increased for PsA (HR = 1.01; 95% CI 0.93 to 1.10). Besides, severe psoriasis did not increase mortality risk compared with mild psoriasis (HR = 1.0; 95% CI 0.95 to 1.06). Conclusions: Patients with psoriasis had a higher mortality risk compared with control subjects, whereas psoriasis severity and presence of PsA had no impact on mortality risk in psoriasis patients.

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Do Children With Constipation Have Increased Risk of Asthma? Real-World Data From a Nationwide Population-Based Cohort Study

Frontiers in Pediatrics ◽

10.3389/fped.2021.714406 ◽

2021 ◽

Vol 9 ◽

Author(s):

Yen-Chu Huang ◽

Meng-Che Wu ◽

Yu-Hsun Wang ◽

James Cheng-Chung Wei

Keyword(s):

Cohort Study ◽

Cox Regression ◽

Population Based ◽

Hazard Ratio ◽

Adjusted Hazard Ratio ◽

Research Database ◽

Real World Data ◽

Childhood Disorders ◽

Cox Regression Analysis ◽

Increased Risk

Background: Asthma is one of the most burdensome childhood disorders. Growing evidence disclose intestinal dysbiosis may contribute to asthma via the gut-lung axis. Constipation can lead to alteration of the gut microbiota. The clinical impact of constipation on asthma has not been researched. Therefore, we aim to assess whether pediatric constipation influence the risk of developing asthma by a nationwide population-based cohort study.Methods: We analyzed 10,363 constipated patients and 10,363 individuals without constipation between 1999 and 2013 from Taiwan's National Health Insurance Research Database. Analysis of propensity score was utilized to match age, sex, comorbidities, and medications at a ratio of 1:1. In addition, multiple Cox regression analysis was performed to evaluate the adjusted hazard ratio of asthma. Furthermore, sensitivity tests and a stratified analysis were performed.Results: After adjustment for age, sex, comorbidities, and medications, constipated patients had a 2.36-fold greater risk of asthma compared to those without constipation [adjusted hazard ratio (aHR): 2.36, 95% C.I. 2.04–2.73, p < 0.001]. Furthermore, the severity of constipation is associated with an increased risk of asthma; the adjusted hazard ratio was 2.25, 2.85, and 3.44 within < 3, 3–12, and ≥12 times of laxatives prescription within 1 year, respectively (p < 0.001).Conclusion: Constipation was correlated with a significantly increased risk of asthma. Pediatricians should be aware of the possibility of asthma in constipated patients. Further research is warranted to investigate the possible pathological mechanisms of this association.

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Bipolar disorder and risk of Parkinson disease

Neurology ◽

10.1212/wnl.0000000000007649 ◽

2019 ◽

Vol 92 (24) ◽

pp. e2735-e2742 ◽

Cited By ~ 7

Author(s):

Mao-Hsuan Huang ◽

Chih-Ming Cheng ◽

Kai-Lin Huang ◽

Ju-Wei Hsu ◽

Ya-Mei Bai ◽

...

Keyword(s):

Bipolar Disorder ◽

Parkinson Disease ◽

Cox Regression ◽

Sensitivity Analyses ◽

Control Group ◽

Research Database ◽

Cox Regression Analysis ◽

Increased Risk ◽

Depressive Episodes

ObjectiveTo evaluate the risk of Parkinson disease (PD) among patients with bipolar disorder (BD).MethodsUsing the Taiwan National Health Insurance Research Database, we examined 56,340 patients with BD and 225,360 age- and sex-matched controls between 2001 and 2009 and followed them to the end of 2011. Individuals who developed PD during the follow-up period were identified.ResultsPatients with BD had a higher incidence of PD (0.7% vs 0.1%, p < 0.001) during the follow-up period than the controls. A Cox regression analysis with adjustments for demographic data and medical comorbid conditions revealed that patients with BD were more likely to develop PD (hazard ratio [HR] 6.78, 95% confidence interval [CI] 5.74–8.02) than the control group. Sensitivity analyses after exclusion of the first year (HR 5.82, 95% CI 4.89–6.93) or first 3 years (HR 4.42; 95% CI 3.63–5.37) of observation showed consistent findings. Moreover, a high frequency of psychiatric admission for manic/mixed and depressive episodes was associated with an increased risk of developing PD.ConclusionPatients with BD had a higher incidence of PD during the follow-up period than the control group. Manic/mixed and depressive episodes were associated with an elevated likelihood of developing PD. Further studies are necessary to investigate the underlying pathophysiology between BD and PD.

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Are Chronic Periodontitis and Gingivitis Associated with Dementia? A Nationwide, Retrospective, Matched-Cohort Study in Taiwan

Neuroepidemiology ◽

10.1159/000449166 ◽

2016 ◽

Vol 47 (2) ◽

pp. 82-93 ◽

Cited By ~ 31

Author(s):

Nian-Sheng Tzeng ◽

Chi-Hsiang Chung ◽

Chin-Bin Yeh ◽

Ren-Yeong Huang ◽

Da-Yo Yuh ◽

...

Keyword(s):

Chronic Periodontitis ◽

Proportional Hazards ◽

Geographic Region ◽

Cox Proportional Hazards ◽

Control Group ◽

Data Sets ◽

Research Database ◽

Urbanization Level ◽

Proportional Hazards Regression

Background: Chronic periodontitis and gingivitis are associated with various diseases; however, their impact on dementia is yet to be elucidated. This study is aimed at investigating the association between chronic periodontitis and gingivitis, and the risk of developing dementia. Methods: A total of 2,207 patients, with newly diagnosed chronic periodontitis and gingivitis between January 1, 2000 and December 31, 2000, were selected from the National Health Insurance Research Database of Taiwan, along with 6,621 controls matched for sex and age. After adjusting for confounding factors, Cox proportional hazards analysis was used to compare the risk of developing dementia during the 10-year follow-up period. Results: Of the study subjects, 25 (1.13%) developed dementia compared to 61 (0.92%) in the control group. Cox proportional hazards regression analysis revealed that the study subjects were more likely to develop dementia (hazard ratio (HR) 2.085, 95% CI 1.552-4.156, p < 0.001). After adjusting for sex, age, monthly income, urbanization level, geographic region, and comorbidities, the HR for dementia was 2.54 (95% CI 1.297-3.352, p = 0.002). Conclusions: Patients with chronic periodontitis and gingivitis have a higher risk of developing dementia. However, further studies on other large or national data sets are required to support the current findings.

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Use of lithium and cancer risk in patients with bipolar disorder: population-based cohort study

The British Journal of Psychiatry ◽

10.1192/bjp.bp.116.181362 ◽

2016 ◽

Vol 209 (5) ◽

pp. 393-399 ◽

Cited By ~ 38

Author(s):

Ru-Yu Huang ◽

Kun-Pin Hsieh ◽

Wan-Wen Huang ◽

Yi-Hsin Yang

Keyword(s):

Bipolar Disorder ◽

Cohort Study ◽

Cancer Risk ◽

Cox Regression ◽

Glycogen Synthase ◽

Control Group ◽

Defined Daily Dose ◽

Research Database ◽

Hazard Ratios ◽

Risk Of Cancer

BackgroundLithium inhibits glycogen synthase kinase-3, which is an enzyme involved in the pathogenesis of cancer.AimsTo investigate the association between lithium and cancer risk in patients with bipolar disorder.MethodA retrospective cohort study was designed using the National Health Insurance Research Database (NHIRD) in Taiwan. Patients using lithium comprised the index drug group and patients using anticonvulsants only comprised the control group. Time-dependent Cox regression was used to evaluate the hazard ratios (HRs) for risk of cancer.ResultsCompared with anticonvulsant-only exposure, lithium exposure was associated with significantly lower cancer risk (HR = 0.735, 95% CI 0.554–0.974). The hazard ratios for the first, second and third tertiles of the cumulative defined daily dose were 0.762 (95% CI 0.516–1.125), 0.919 (95% CI 0.640–1.318) and 0.552 (95% CI 0.367–0.831), respectively.ConclusionsLithium is associated with reduced overall cancer risk in patients with bipolar disorder. A dose–response relationship for cancer risk reduction was observed.

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Dermatologic Vasculature Diseases as a Risk Factor of Subconjunctival Hemorrhage

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16162865 ◽

2019 ◽

Vol 16 (16) ◽

pp. 2865

Author(s):

Chia-Yi Lee ◽

Hung-Chi Chen ◽

Jing-Yang Huang ◽

Chi-Chin Sun ◽

Chao-Bin Yeh ◽

...

Keyword(s):

Risk Factor ◽

Survival Analysis ◽

Cox Regression ◽

Cumulative Probability ◽

Control Group ◽

Study Group ◽

Research Database ◽

Cox Regression Analysis ◽

Subconjunctival Hemorrhage ◽

The Relationship

To evaluate the relationship between subconjunctival hemorrhage (SCH) and dermatologic vasculature diseases (DVDs) via the national health insurance research database (NHIRD) of Taiwan. This retrospective cohort study used data from the NHIRD for the 2009 to 2013 period. Patients diagnosed with DVDs were enrolled in the study group, and a propensity score-matching population was selected as the control group after exclusion. The main outcome was set as the development of SCH in both groups. Multivariable Cox regression analysis and survival analysis were performed to estimate the adjusted hazard ratio (aHR) and cumulative probability of SCH. A total number of 3426 patients were enrolled and split equally into the study and the control groups. There was no prominent difference between the age, gender, urbanization, income level, systemic co-morbidities, and ocular diseases between the two groups after matching. During the whole study period, 131 patients in the study group and 98 patients in the control group developed SCH with a significant higher aHR of 2.69 in the study group (p < 0.05). In the survival analysis, the study group also demonstrated a higher cumulative probability of developing SCH than the control group throughout the study period (p = 0.02). In conclusion, the presence of DVDs may be a risk factor for the development of SCH.

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