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

Tim Wilkinson*, Christian Schnier, Kathryn Bush, Kristiina Rannikmäe, Ronan A. Lyons, Stuart McTaggart, Marion Bennie, Cathie L.M. Sudlow

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

13 Citations (Scopus)

Abstract

Background 

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. 

Methods 

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. 

Results 

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. 

Conclusions 

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.

Original languageEnglish
Pages (from-to)223-229
Number of pages7
JournalJournal of Epidemiology and Community Health
Volume76
Issue number3
Early online date27 Oct 2021
DOIs
Publication statusPublished - 01 Mar 2022
Externally publishedYes

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health

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