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@ARTICLE{Rakua:258784,
author = {Rakuša, Elena and Fink, Anne and Tamgüney, Gültekin and
Heneka, Michael and Doblhammer, Gabriele},
title = {{S}poradic {U}se of {A}ntibiotics in {O}lder {A}dults and
the {R}isk of {D}ementia: {A} {N}ested {C}ase-{C}ontrol
{S}tudy {B}ased on {G}erman {H}ealth {C}laims {D}ata.},
journal = {Journal of Alzheimer's disease},
volume = {93},
number = {4},
issn = {1387-2877},
address = {Amsterdam},
publisher = {IOS Press},
reportid = {DZNE-2023-00678},
pages = {1329 - 1339},
year = {2023},
abstract = {Antibiotics for systemic use may increase the risk of
neurodegeneration, yet antibiotic therapy may be able to
halt or mitigate an episode of neurodegenerative decline.To
investigate the association of sporadic use of antibiotics
and subsequent dementia risk (including Alzheimer's
disease).We used data from the largest public health
insurance fund in Germany, the Allgemeine Ortskrankenkasse
(AOK). Each of the 35,072 dementia cases aged 60 years and
older with a new dementia diagnosis during the observation
period from 2006 to 2018 was matched with two
control-patients by age, sex, and time since 2006. We ran
conditional logistic regression models for dementia risk in
terms of odds ratios (OR) as a function of antibiotic use
for the entire antibiotic group and for each antibiotic
subgroup. We controlled for comorbidities, need for
long-term care, hospitalizations, and nursing home
placement.Antibiotic use was positively associated with
dementia (OR = 1.18, $95\%$ confidence interval $(95\%$
CI):1.14-1.22), which became negative after adjustment for
comorbidities, at least one diagnosis of bacterial infection
or disease, and covariates (OR = 0.93, $95\%$ CI:0.90-0.96).
Subgroups of antibiotics were also negatively associated
with dementia after controlling for covariates:
tetracyclines (OR = 0.94, $95\%$ CI:0.90-0.98), beta-lactam
antibacterials, penicillins (OR = 0.93, $95\%$
CI:0.90-0.97), other beta-lactam antibacterials (OR = 0.92,
$95\%$ CI:0.88-0.95), macrolides, lincosamides, and
streptogramins (OR = 0.88, $95\%$ CI:0.85-0.92), and
quinolone antibacterials (OR = 0.96, $95\%$
CI:0.92-0.99).Our results suggest that there was a decreased
likelihood of dementia for preceding antibiotic use. The
benefits of antibiotics in reducing inflammation and thus
the risk of dementia need to be carefully weighed against
the increase in antibiotic resistance.},
keywords = {Humans / Middle Aged / Aged / Anti-Bacterial Agents:
adverse effects / Case-Control Studies / Comorbidity /
Dementia: drug therapy / Dementia: epidemiology / Dementia:
diagnosis / beta-Lactams / Alzheimer’s disease (Other) /
Alzheimer’s disease (Other) / antibiotics (Other) /
conditional logistic regression (Other) / dementia (Other) /
epidemiology (Other) / nested case-control studies (Other) /
Anti-Bacterial Agents (NLM Chemicals) / beta-Lactams (NLM
Chemicals)},
cin = {AG Doblhammer-Reiter},
ddc = {610},
cid = {I:(DE-2719)1012002},
pnm = {354 - Disease Prevention and Healthy Aging (POF4-354)},
pid = {G:(DE-HGF)POF4-354},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:37182873},
doi = {10.3233/JAD-221153},
url = {https://pub.dzne.de/record/258784},
}