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Influenza Vaccination Reduces Dementia Risk in Chronic Kidney Disease Patients: A
Population-Based Cohort Study
#MMPMID26945371
Liu JC
; Hsu YP
; Kao PF
; Hao WR
; Liu SH
; Lin CF
; Sung LC
; Wu SY
Medicine (Baltimore)
2016[Mar]; 95
(9
): e2868
PMID26945371
show ga
Taiwan has the highest prevalence of chronic kidney disease (CKD) worldwide. CKD,
a manifestation of vascular diseases, is associated with a high risk of dementia.
Here, we estimated the association between influenza vaccination and dementia
risk in patients with CKD. Data from the National Health Insurance Research
Database of Taiwan were used in this study. The study cohort included all
patients diagnosed with CKD (according to International Classification of
Disease, Ninth Revision, Clinical Modification codes) at healthcare facilities in
Taiwan (n = 32,844) from January 1, 2000, to December 31, 2007. Each patient was
followed up to assess dementia risk or protective factors: demographic
characteristics of age and sex; comorbidities of diabetes, hypertension,
dyslipidemia, cerebrovascular diseases, parkinsonism, epilepsy, substance and
alcohol use disorders, mood disorder, anxiety disorder, psychotic disorder, and
sleep disorder; urbanization level; monthly income; and statin, metformin,
aspirin, and angiotensin-converting enzyme inhibitor (ACEI) use. A propensity
score was derived using a logistic regression model for estimating the effect of
vaccination by accounting for covariates that predict receiving the intervention
(vaccine). A time-dependent Cox proportional hazard model was used to calculate
the hazard ratios (HRs) of dementia among vaccinated and unvaccinated CKD
patients. The study population comprised 11,943 eligible patients with CKD; 5745
(48%) received influenza vaccination and the remaining 6198 (52%) did not. The
adjusted HRs (aHRs) of dementia decreased in vaccinated patients compared with
those in unvaccinated patients (influenza season, noninfluenza season, and all
seasons: aHRs?=?0.68, 0.58, and 0.64; P?
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