Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Mar 23:14:771486.
doi: 10.3389/fnagi.2022.771486. eCollection 2022.

Association Between Antibiotic Treatment of Leptospirosis Infections and Reduced Risk of Dementia: A Nationwide, Cohort Study in Taiwan

Pei-Chun Chao  1   2 , Wu-Chien Chien  3   4   5   6 , Chi-Hsiang Chung  3   4   6 , Chih-Kang Huang  7 , Hao-Ming Li  8 , Nian-Sheng Tzeng  1   9
Affiliations

Association Between Antibiotic Treatment of Leptospirosis Infections and Reduced Risk of Dementia: A Nationwide, Cohort Study in Taiwan

Pei-Chun Chao et al. Front Aging Neurosci. .

Abstract

Background: To explore the association between leptospirosis, the risk of dementia, and the potential protective role of antibiotic treatment.

Methods: We conducted a retrospective cohort nationwide, population-based study, from Taiwan's National Health Insurance Research Database (NHIRD). We enrolled 1,428 subjects aged 50 years or above, in the index year of 2000, which included those retrieved from the NHIRD record. Dementia diagnosis and incidence over 16 years follow-up was retrieved from the NHIRD records. The Fine and Gray survival analysis was used to determine the risk of dementia, and the results were presented as a sub-distribution hazard ratio (SHR) with a 95% confidence interval.

Results: In the study period, 43 of the 357 leptospirosis patients developed dementia, as compared to 103 of the control group (930.90 vs. 732.49 per 105 person-years). By the Fine and Gray survival analysis, the leptospirosis was associated with the risk of dementia, and the adjusted SHR was 1.357 (95% confidence interval [CI]: 1.213-1.519, P < 0.001), across 16-year of the follow-up period. To exclude the protopathic bias, the sensitivity analysis was conducted. This analysis revealed that the leptospirosis was associated with the increased risk of dementia, even after excluding the dementia diagnosis within the first year (adjusted SHR = 1.246, 95%CI: 1.114-1.395, P < 0.001) or within the first 5 years (adjusted SHR = 1.079, 95%CI: 1.023-1.152, P = 0.028), antibiotic treatment for leptospirosis was associated with the reduced risk of dementia (P = 0.001).

Conclusion: Leptospirosis was associated with an increased risk for dementia, and antibiotic treatment was associated with a reduced risk. Further research will be necessary to explore the underlying mechanisms of this association.

Keywords: antibiotic; dementia; leptospirosis; risk; time-dependent.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
The flowchart of study sample selection.
FIGURE 2
FIGURE 2
Kaplan–Meier for cumulative incidence of dementia aged 50 and over stratified by Leptospirosis infections with log-rank test.
FIGURE 3
FIGURE 3
The flowchart of study sample selection with or without antibiotic treatment.
FIGURE 4
FIGURE 4
Kaplan–Meier for cumulative incidence of dementia aged 50 and over stratified by Leptospirosis infections with or without antibiotics, with log-rank test.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. American Psychiatric Association [APA] (1994). Diagnostic and Statistical Manual of Mental Disorders, (DSM-IV), 4th Edn. Virginia, VA: American Psychiatric Association.
    1. American Psychiatric Association [APA] (2000). Diagnostic and Statistical Manual of Mental Disorders, Text Revision (DSM-IV-TR), 4th Edn. Virginia, VA: American Psychiatric Association.
    1. Balducci C., Forloni G. (2019). Doxycycline for Alzheimer’s Disease: fighting β-Amyloid oligomers and neuroinflammation. Front. Pharmacol. 10:738. 10.3389/fphar.2019.00738 - DOI - PMC - PubMed
    1. Barage S. H., Sonawane K. D. (2015). Amyloid cascade hypothesis: pathogenesis and therapeutic strategies in Alzheimer’s disease. Neuropeptides 52 1–18. 10.1016/j.npep.2015.06.008 - DOI - PubMed
    1. Barnes L. L., Capuano A. W., Aiello A. E., Turner A. D., Yolken R. H., Torrey E. F., et al. (2015). Cytomegalovirus infection and risk of Alzheimer disease in older black and white individuals. J. Infect. Dis. 211 230–237. 10.1093/infdis/jiu437 - DOI - PMC - PubMed

LinkOut - more resources