PDF(Pubmed)
Abstract：
Heat-related illness (HRI) is commonly considered an acute condition, and its potential long-term consequences are not well understood. We conducted a population-based cohort study and an animal experiment to evaluate whether HRI is associated with dementia later in life.
The Taiwan National Health Insurance Research Database was used in the epidemiological study. We identified newly diagnosed HRI patients between 2001 and 2015, but excluded those with any pre-existing dementia, as the study cohort. Through matching by age, sex, and the index date with the study cohort, we selected individuals without HRI and without any pre-existing dementia as a comparison cohort at a 1:4 ratio. We followed each cohort member until the end of 2018 and compared the risk between the two cohorts using Cox proportional hazards regression models. In the animal experiment, we used a rat model to assess cognitive functions and the histopathological changes in the hippocampus after a heat stroke event.
In the epidemiological study, the study cohort consisted of 70,721 HRI patients and the comparison cohort consisted of 282,884 individuals without HRI. After adjusting for potential confounders, the HRI patients had a higher risk of dementia (adjusted hazard ratio [AHR] = 1.24; 95% confidence interval [CI]: 1.19-1.29). Patients with heat stroke had a higher risk of dementia compared with individuals without HRI (AHR = 1.26; 95% CI: 1.18-1.34). In the animal experiment, we found cognitive dysfunction evidenced by animal behavioral tests and observed remarkable neuronal damage, degeneration, apoptosis, and amyloid plaque deposition in the hippocampus after a heat stroke event.
Our epidemiological study indicated that HRI elevated the risk of dementia. This finding was substantiated by the histopathological features observed in the hippocampus, along with the cognitive impairments detected, in the experimental heat stroke rat model.
The Taiwan National Health Insurance Research Database was used in the epidemiological study. We identified newly diagnosed HRI patients between 2001 and 2015, but excluded those with any pre-existing dementia, as the study cohort. Through matching by age, sex, and the index date with the study cohort, we selected individuals without HRI and without any pre-existing dementia as a comparison cohort at a 1:4 ratio. We followed each cohort member until the end of 2018 and compared the risk between the two cohorts using Cox proportional hazards regression models. In the animal experiment, we used a rat model to assess cognitive functions and the histopathological changes in the hippocampus after a heat stroke event.
In the epidemiological study, the study cohort consisted of 70,721 HRI patients and the comparison cohort consisted of 282,884 individuals without HRI. After adjusting for potential confounders, the HRI patients had a higher risk of dementia (adjusted hazard ratio [AHR] = 1.24; 95% confidence interval [CI]: 1.19-1.29). Patients with heat stroke had a higher risk of dementia compared with individuals without HRI (AHR = 1.26; 95% CI: 1.18-1.34). In the animal experiment, we found cognitive dysfunction evidenced by animal behavioral tests and observed remarkable neuronal damage, degeneration, apoptosis, and amyloid plaque deposition in the hippocampus after a heat stroke event.
Our epidemiological study indicated that HRI elevated the risk of dementia. This finding was substantiated by the histopathological features observed in the hippocampus, along with the cognitive impairments detected, in the experimental heat stroke rat model.
摘要：
背景：与热有关的疾病（HRI）通常被认为是一种急性疾病，其潜在的长期后果还没有得到很好的理解。我们进行了一项基于人群的队列研究和一项动物实验，以评估HRI是否与以后生活中的痴呆有关。
方法：流行病学研究使用台湾国民健康保险研究数据库。我们确定了2001年至2015年期间新诊断的HRI患者，但排除了任何先前存在的痴呆症患者。作为研究队列。通过按年龄匹配，性别,以及研究队列的索引日期，我们选择没有HRI和没有任何已存在痴呆的个体作为比较队列,比例为1∶4.我们跟踪每个队列成员直到2018年底，并使用Cox比例风险回归模型比较两个队列之间的风险。在动物实验中,我们使用大鼠模型评估中暑事件后的认知功能和海马组织病理学变化.
结果：在流行病学研究中，研究队列由70,721例HRI患者组成,比较队列由282,884例无HRI患者组成.在调整了潜在的混杂因素后，HRI患者的痴呆风险较高(校正后风险比[AHR]=1.24;95%置信区间[CI]:1.19~1.29).与没有HRI的患者相比，中暑患者患痴呆的风险更高(AHR=1.26;95%CI:1.18-1.34)。在动物实验中,我们发现动物行为测试证明了认知功能障碍，并观察到显着的神经元损伤，变性,凋亡，中暑事件后海马中淀粉样蛋白斑块沉积。
结论：我们的流行病学研究表明HRI增加了痴呆的风险。这一发现被海马中观察到的组织病理学特征所证实，以及检测到的认知障碍，在实验性中暑大鼠模型中。
方法：流行病学研究使用台湾国民健康保险研究数据库。我们确定了2001年至2015年期间新诊断的HRI患者，但排除了任何先前存在的痴呆症患者。作为研究队列。通过按年龄匹配，性别,以及研究队列的索引日期，我们选择没有HRI和没有任何已存在痴呆的个体作为比较队列,比例为1∶4.我们跟踪每个队列成员直到2018年底，并使用Cox比例风险回归模型比较两个队列之间的风险。在动物实验中,我们使用大鼠模型评估中暑事件后的认知功能和海马组织病理学变化.
结果：在流行病学研究中，研究队列由70,721例HRI患者组成,比较队列由282,884例无HRI患者组成.在调整了潜在的混杂因素后，HRI患者的痴呆风险较高(校正后风险比[AHR]=1.24;95%置信区间[CI]:1.19~1.29).与没有HRI的患者相比，中暑患者患痴呆的风险更高(AHR=1.26;95%CI:1.18-1.34)。在动物实验中,我们发现动物行为测试证明了认知功能障碍，并观察到显着的神经元损伤，变性,凋亡，中暑事件后海马中淀粉样蛋白斑块沉积。
结论：我们的流行病学研究表明HRI增加了痴呆的风险。这一发现被海马中观察到的组织病理学特征所证实，以及检测到的认知障碍，在实验性中暑大鼠模型中。
