Pneumoconiosis and the subsequent risk of dementia: a retrospective cohort study

Abstract

Background: Pneumoconiosis has been recognized as a risk factor for systemic diseases; however, its association with dementia remains unclear. This study aims to investigate the association of pneumoconiosis with the subsequent risk of dementia.

Methods: This retrospective cohort study used data from Taiwan's National Health Insurance database. The pneumoconiosis cohort included 17 871 patients diagnosed with pneumoconiosis from 2009 to 2020. A comparison cohort of 71 484 individuals without pneumoconiosis was matched in a 1:4 ratio in terms of age, sex, and diagnostic date. All study participants were followed up until the end of 2020 to evaluate dementia incidence.

Results: The incidence of dementia in the pneumoconiosis cohort was 17.6 per 1000 person-years, which was significantly higher than the 12.3 per 1000 person-years in the control group. Age-stratified analysis revealed that patients aged 65-74 years (aHR = 1.26, 95% CI = 1.15-1.38) and ≥75 years (aHR = 1.49, 95% CI = 1.38-1.60) demonstrated a significantly increased risk. Sex-specific analysis revealed that both men (aHR = 1.39, 95% CI = 1.31-1.48) and women (aHR = 1.30, 95% CI = 1.11-1.51) exhibited a significantly increased risk. Further, the frequency of emergency department visits among patients with pneumoconiosis was positively associated with dementia risk.

Conclusion: Utilizing a large-scale medical database, this study reveals that patients with pneumoconiosis demonstrated a significantly increased risk of developing dementia. Early cognitive function screening is recommended for this population to reduce disability and improve long-term outcomes. Key messages What is already known on this topic: Pneumoconiosis has considerable comorbidities, particularly pulmonary and cardiovascular diseases. However, the association between pneumoconiosis and dementia is largely unknown. What this study adds: The nationwide, population-based, retrospective cohort study revealed that patients with pneumoconiosis had a significantly higher risk of dementia than those without pneumoconiosis. How this study might affect research, practice, or policy: Greater emphasis on early cognitive function screening in this population may help to reduce disability rates and enhance long-term outcomes.

Keywords: cohort study; dementia; pneumoconiosis.