OBJECTIVE: To assess the association between four groups of psychiatric disorders (schizophrenia, bipolar disorder/mania, depression and anxiety) with dementia in two large population-based samples with EHR.
METHODS: Using EHR on nearly 1 million adult individuals in Wales, and from 228 937 UK Biobank participants, we studied the relationships between schizophrenia, mania/bipolar disorder, depression, anxiety and subsequent risk of dementia.
RESULTS: In Secure Anonymised Information Linkage, there was a steep increase in the incidence of a first diagnosis of psychiatric disorder in the years prior to the diagnosis of dementia, reaching a peak in the year prior to dementia diagnosis for all psychiatric diagnoses. Psychiatric disorders, except anxiety, were highly significantly associated with a subsequent diagnosis of dementia: HRs=2.87, 2.80, 1.63 for schizophrenia, mania/bipolar disorder and depression, respectively. A similar pattern was found in the UK Biobank (HRs=4.46, 3.65, 2.39, respectively) and anxiety was also associated with dementia (HR=1.34). Increased risk of dementia was observed for all ages at onset of psychiatric diagnoses when these were divided into 10-year bins.
CONCLUSIONS: Psychiatric disorders are associated with an increased risk of subsequent dementia, with a greater risk of more severe disorders.
CONCLUSIONS: A late onset of psychiatric disorders should alert clinicians of possible incipient dementia.
目的:评估四组精神疾病(精神分裂症,双相情感障碍/躁狂症,抑郁和焦虑)在两个基于人群的大型EHR样本中伴有痴呆。
方法:在威尔士近100万成年人身上使用EHR,来自228937名英国生物银行参与者,我们研究了精神分裂症之间的关系,躁狂症/双相情感障碍,抑郁症,焦虑和随后患痴呆症的风险。
结果:在安全的匿名信息链接中,在痴呆症诊断之前的几年中,首次诊断为精神疾病的发病率急剧增加,所有精神病诊断在痴呆症诊断前一年达到高峰。精神病,除了焦虑,与随后的痴呆诊断高度显著相关:精神分裂症的HR=2.87,2.80,1.63,躁狂症/双相情感障碍和抑郁症,分别。在英国生物银行中发现了类似的模式(HR分别为4.46、3.65、2.39),焦虑也与痴呆相关(HR=1.34)。当将这些疾病分为10年分类时,所有年龄在精神病诊断开始时都观察到痴呆的风险增加。
结论:精神疾病与随后的痴呆风险增加有关,患更严重疾病的风险更大。
结论:晚发性精神疾病应提醒临床医生注意可能的初期痴呆。