Journal Article Annotations
2022, 3rd Quarter
Annotations by Ashwini Nadkarni, MD
This nationwide cohort study used a database of the entire Danish population (1977-2018) to examine the association between IBD and dementia, including less common dementia subtypes. In a nested case–control analysis, the authors also examined the impact of IBD severity, colorectal or small bowel surgery, steroid use and frequency of healthcare system contacts on dementia risk. Ulcerative colitis patients were found to have a slightly increased risk of Alzheimer’s disease while Crohn’s Disease patients had an increased risk of frontotemporal dementia.
Strength and weaknesses:
This study is the first to investigate the risk of frontotemporal dementia and Parkinson’s disease dementia/Lewy body disease in IBD patients. However, the validity of this study was threatened by the higher frequency healthcare system contact among IBD patients—perhaps IBD patients are more likely to be diagnosed. Finally, the authors did not have access to data on educational level, personal income level, employment status and lifestyle covariables including smoking, alcohol consumption and dietary habits from the included Danish registries.
The study suggests that patients who have IBD are at risk of developing further neuropsychiatric diseases such as dementia. This relationship may relate to the negative impact of chronic inflammation on hippocampal neurogenesis, which is thought to underlie the behavioral sequelae of IBD. C-L psychiatrists caring for the geriatric IBD patient population should be attentive to cognitive impairments, whether owing depression, mild cognitive impairment, or early symptoms of dementia.