The risk of dementia in multiple sclerosis and neuromyelitis optica spectrum disorder

Eun Bin Cho; Se Young Jung; Jin-Hyung Jung; Yohwan Yeo; Hee Jin Kim; Kyungdo Han; Dong Wook Shin; Ju-Hong Min

doi:10.3389/fnins.2023.1214652

The risk of dementia in multiple sclerosis and neuromyelitis optica spectrum disorder

Front Neurosci. 2023 Jun 15:17:1214652. doi: 10.3389/fnins.2023.1214652. eCollection 2023.

Authors

Eun Bin Cho^#^{1

2}, Se Young Jung^#^{3

4}, Jin-Hyung Jung⁵, Yohwan Yeo⁶, Hee Jin Kim^{7

8

9}, Kyungdo Han¹⁰, Dong Wook Shin^{11

12

13

14}, Ju-Hong Min^{7

8

9}

Affiliations

¹ Department of Neurology, College of Medicine, Gyeongsang Institute of Health Science, Gyeongsang National University, Jinju, Republic of Korea.
² Department of Neurology, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea.
³ Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
⁴ Department of Digital Healthcare, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
⁵ Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea.
⁶ Department of Family Medicine, College of Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Republic of Korea.
⁷ Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
⁸ Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea.
⁹ Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea.
¹⁰ Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea.
¹¹ Department of Family Medicine and Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
¹² Department of Clinical Research Design and Evaluation, Sungkyunkwan University, Seoul, Republic of Korea.
¹³ Department of Digital Health, Samsung Advanced Institute of Health Science and Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea.
¹⁴ Center for Wireless and Population Health Systems, University of California San Diego, La Jolla, CA, United States.

^# Contributed equally.

Abstract

Introduction: Cognitive impairment is a common feature of multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD). However, there is a lack of population-based study of dementia risk in these disorders. In the present study, the risk of dementia in MS and NMOSD patients in Republic of Korea was estimated.

Methods: Data analyzed in this study were obtained from the Korean National Health Insurance Service (KNHIS) database between January 2010 and December 2017. The study included 1,347 MS patients and 1,460 NMOSD patients ≥40 years of age who had not been diagnosed with dementia within 1 year prior to the index date. Matched controls were selected based on age, sex, and the presence of hypertension, diabetes mellitus, or dyslipidemia.

Results: In MS and NMOSD patients, the risk of developing any dementia [adjusted hazard ratio (aHR) = 2.34; 95% confidence interval (CI) = 1.84-2.96 and aHR = 2.19; 95% CI = 1.61-3.00, respectively], Alzheimer's disease [AD; aHR = 2.23; 95% confidence interval (CI) = 1.70-2.91 and aHR = 1.99; 95% CI = 1.38-2.88, respectively], and vascular dementia (aHR = 3.75; 95% CI = 1.91-7.35 and aHR = 3.21; 95% CI = 1.47-7.02, respectively) was higher compared with the matched controls. NMOSD patients had a lower risk of any dementia and AD compared with MS patients after adjusting for age, sex, income, hypertension, diabetes, and dyslipidemia (aHR = 0.67 and 0.62).

Conclusion: The risk of dementia increased in MS and NMOSD patients and dementia risk was higher in MS than in NMOSD.

Keywords: dementia; multiple sclerosis; neuromyelitis optica spectrum disorders; population; risk.

Grants and funding

This research was partially supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI20C1073). The funding source was not involved in the study design, data collection, data analysis, or data interpretation of this study.