IBD patients at higher risk of developing Alzheimer’s disease

Inflammatory bowel disease (IBD) shows an independent relationship with the development of Alzheimer’s disease (AD), with such association being stronger in patients with Crohn’s disease (CD) than those with ulcerative colitis (UC), reveals a study.

In addition, use of tumour necrosis factor (TNF-α) inhibitors appears beneficial in reducing the likelihood of AD development.

A team of investigators examined the association of IBD with AD development by surveying a commercial database, Explorys Inc., an aggregate of electronic health records from 26 major US healthcare systems. They identified patients with Systematized Nomenclature of Medicine—Clinical Terms (SNOMED-CT) diagnoses of Crohn’s disease (CD), ulcerative colitis (UC), and AD.

IBD patients who were newly diagnosed with AD were characterized according to demographic and traditional AD risk factors and IBD-related features.

A total of 342,740 patients with IBD were identified in the database, of whom 5,750 (1.55 percent) developed AD. After adjustments made for traditional AD risk factors, IBD was found to be independently associated with the development of AD (odds ratio [OR], 2.30, 95 percent confidence interval [CI], 2.10‒2.51). Notably, IBD patients with AD were younger than AD patients without IBD.

Subgroup analysis revealed a higher likelihood of developing AD among patients with CD (adjusted OR, 3.34, 95 percent CI, 3.25‒3.42) than those with UC (adjusted OR, 1.09, 95 percent CI, 1.06‒1.14).

Furthermore, use of TNF-α inhibitors in IBD significantly correlated with a lower chance of developing AD in both CD and UC cohorts.

“AD affects 5 million Americans and early recognition improves cognitive function,” the investigators said. “Chronic inflammation and gut microbiome alteration are linked to cognitive decline which are common in IBD.”