Increased Incident Alzheimer's Disease among Individuals with Varicose Veins: A Population-Based Cohort Study

Abstract

Background: Varicose vein may be related to increased risk of comorbidities and decreased cognitive function in the elderly, but little is known about the association between varicose vein and Alzheimer's disease.

Objectives: To evaluate whether there is an association between varicose veins and Alzheimer's disease.

Design: The study subjects of this cohort study were selected based on Chang Gung Research Database from January 1, 2003, to December 31, 2012. Follow-up ended December 31, 2017.

Setting: A population-based study Participants: Patients aged 45 years and older with varicose veins were enrolled, and the participants of control group were selected by matching with gender, age, and index date at a 4:1 ratio.

Measurements: The hazard ratios associated with varicose veins were estimated using Cox regression analysis with competitive risk model. Incidence rates of Alzheimer's disease, was assessed in people with and without varicose veins.

Results: A total of 9,601 patients with varicose veins and 38,404 matched controls were enrolled in the study. The varicose veins group had higher incidence rates than the control group for Alzheimer's disease (12.60 vs 6.24 per 10,000 person-years; Hazard ratio, 1.647 [95% confidence interval, 1.326- 2.045, p<0.001]). Patients with complicated varicose veins had increased incidence of Alzheimer's disease than uncomplicated cases (adjusted HR, 1.474; 95% CI, 1.034-2.101, P=0.032).

Conclusion: The present study demonstrated a positive association between the varicose veins and Alzheimer's disease. Physicians should be alerted to cognitive function in patients with varicose veins, especially those with presence of inflammation and ulcerations.

Keywords: Alzheimer’s disease; dementia; tumor necrosis factor; varicose vein.