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Drug prescriptions and dementia incidence: a medication-wide association study of 17000 dementia cases among half a million participants

Tim Wilkinson Orcid Logo, Christian Schnier, Kathryn Bush, Kristiina Rannikmäe, Ronan Lyons Orcid Logo, Stuart McTaggart, Marion Bennie, Cathie LM Sudlow

Journal of Epidemiology and Community Health, Volume: 76, Issue: 3, Pages: 223 - 229

Swansea University Author: Ronan Lyons Orcid Logo

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DOI (Published version): 10.1136/jech-2021-217090

Abstract

Previous studies have suggested that some medications may influence dementia risk. We conducted a hypothesis-generating medication-wide association study to investigate systematically the association between all prescription medications and incident dementia. We used a population-based cohort within...

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Published in: Journal of Epidemiology and Community Health
ISSN: 0143-005X 1470-2738
Published: BMJ 2022
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URI: https://cronfa.swan.ac.uk/Record/cronfa58618
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spelling 2022-08-16T11:57:41.8500610 v2 58618 2021-11-11 Drug prescriptions and dementia incidence: a medication-wide association study of 17000 dementia cases among half a million participants 83efcf2a9dfcf8b55586999d3d152ac6 0000-0001-5225-000X Ronan Lyons Ronan Lyons true false 2021-11-11 HDAT Previous studies have suggested that some medications may influence dementia risk. We conducted a hypothesis-generating medication-wide association study to investigate systematically the association between all prescription medications and incident dementia. We used a population-based cohort within the Secure Anonymised Information Linkage (SAIL) databank, comprising routinely-collected primary care, hospital admissions and mortality data from Wales, UK. We included all participants born after 1910 and registered with a SAIL general practice at ≤60 years old. Follow-up was from each participant's 60th birthday to the earliest of dementia diagnosis, deregistration from a SAIL general practice, death or the end of 2018. We considered participants exposed to a medication if they received ≥1 prescription for any of 744 medications before or during follow-up. We adjusted for sex, smoking and socioeconomic status. The outcome was any all-cause dementia code in primary care, hospital or mortality data during follow-up. We used Cox regression to calculate hazard ratios and Bonferroni-corrected p values. Of 551 344 participants, 16 998 (3%) developed dementia (median follow-up was 17 years for people who developed dementia, 10 years for those without dementia). Of 744 medications, 221 (30%) were associated with dementia. Of these, 217 (98%) were associated with increased dementia incidence, many clustering around certain indications. Four medications (all vaccines) were associated with a lower dementia incidence. Almost a third of medications were associated with dementia. The clustering of many drugs around certain indications may provide insights into early manifestations of dementia. We encourage further investigation of hypotheses generated by these results. [Abstract copyright: © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.] Journal Article Journal of Epidemiology and Community Health 76 3 223 229 BMJ 0143-005X 1470-2738 neuroepidemiology, dementia, record linkage, pharmacoepidemiology 10 2 2022 2022-02-10 10.1136/jech-2021-217090 COLLEGE NANME Health Data Science COLLEGE CODE HDAT Swansea University Another institution paid the OA fee The creation of the Secure Anonymised Information Linkage Databank Dementia electronic Cohort was funded by Dementias Platform UK (MR/L015382/1). TW was funded by a Medical Research Council Clinical Research Training Fellowship (MR/P001823/1). 2022-08-16T11:57:41.8500610 2021-11-11T13:06:18.1711810 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Tim Wilkinson 0000-0001-8952-0982 1 Christian Schnier 2 Kathryn Bush 3 Kristiina Rannikmäe 4 Ronan Lyons 0000-0001-5225-000X 5 Stuart McTaggart 6 Marion Bennie 7 Cathie LM Sudlow 8 58618__21492__f8b13cbd83404811a2d90a4e34ae83ae.pdf 58618.pdf 2021-11-11T13:09:26.8003939 Output 737538 application/pdf Version of Record true This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license true eng https://creativecommons.org/licenses/by/4.0/
title Drug prescriptions and dementia incidence: a medication-wide association study of 17000 dementia cases among half a million participants
spellingShingle Drug prescriptions and dementia incidence: a medication-wide association study of 17000 dementia cases among half a million participants
Ronan Lyons
title_short Drug prescriptions and dementia incidence: a medication-wide association study of 17000 dementia cases among half a million participants
title_full Drug prescriptions and dementia incidence: a medication-wide association study of 17000 dementia cases among half a million participants
title_fullStr Drug prescriptions and dementia incidence: a medication-wide association study of 17000 dementia cases among half a million participants
title_full_unstemmed Drug prescriptions and dementia incidence: a medication-wide association study of 17000 dementia cases among half a million participants
title_sort Drug prescriptions and dementia incidence: a medication-wide association study of 17000 dementia cases among half a million participants
author_id_str_mv 83efcf2a9dfcf8b55586999d3d152ac6
author_id_fullname_str_mv 83efcf2a9dfcf8b55586999d3d152ac6_***_Ronan Lyons
author Ronan Lyons
author2 Tim Wilkinson
Christian Schnier
Kathryn Bush
Kristiina Rannikmäe
Ronan Lyons
Stuart McTaggart
Marion Bennie
Cathie LM Sudlow
format Journal article
container_title Journal of Epidemiology and Community Health
container_volume 76
container_issue 3
container_start_page 223
publishDate 2022
institution Swansea University
issn 0143-005X
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doi_str_mv 10.1136/jech-2021-217090
publisher BMJ
college_str Faculty of Medicine, Health and Life Sciences
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hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
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description Previous studies have suggested that some medications may influence dementia risk. We conducted a hypothesis-generating medication-wide association study to investigate systematically the association between all prescription medications and incident dementia. We used a population-based cohort within the Secure Anonymised Information Linkage (SAIL) databank, comprising routinely-collected primary care, hospital admissions and mortality data from Wales, UK. We included all participants born after 1910 and registered with a SAIL general practice at ≤60 years old. Follow-up was from each participant's 60th birthday to the earliest of dementia diagnosis, deregistration from a SAIL general practice, death or the end of 2018. We considered participants exposed to a medication if they received ≥1 prescription for any of 744 medications before or during follow-up. We adjusted for sex, smoking and socioeconomic status. The outcome was any all-cause dementia code in primary care, hospital or mortality data during follow-up. We used Cox regression to calculate hazard ratios and Bonferroni-corrected p values. Of 551 344 participants, 16 998 (3%) developed dementia (median follow-up was 17 years for people who developed dementia, 10 years for those without dementia). Of 744 medications, 221 (30%) were associated with dementia. Of these, 217 (98%) were associated with increased dementia incidence, many clustering around certain indications. Four medications (all vaccines) were associated with a lower dementia incidence. Almost a third of medications were associated with dementia. The clustering of many drugs around certain indications may provide insights into early manifestations of dementia. We encourage further investigation of hypotheses generated by these results. [Abstract copyright: © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.]
published_date 2022-02-10T04:15:17Z
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