Surgical repair of aortic aneurysms and reduced incidence of dementia

Abstract

Background: Dementia and aortic aneurysms share clinical risk factors and molecular signaling pathways. However, the association between dementia and aortic aneurysms has not been examined. The potential effects of open surgical repair (OSR) of aortic aneurysms on future dementia events are unknown.

Methods: We conducted this nationwide population-based, retrospective cohort study using the Taiwanese National Health Insurance Research Database (NHIRD). The cumulative incidence of dementia over a 13-yearfollow-up period was compared among 1)aortic aneurysms and non-aortic aneurysm patients and 2)aortic aneurysm patients who underwent OSR, endovascular aneurysm repair (EVAR) or nonsurgical treatment (NST).

Results: This study enrolled 19,921 aortic aneurysms patients and 19,921 matched controls. The aortic aneurysm cohort exhibited a significantly increased incidence of dementia compared with the controls (adjusted hazard ratio (HR)=3.559, p<0.001). Furthermore, 5409 aortic aneurysm patients were treated with surgical intervention, whereas 5409 matched aortic aneurysm patients were not. Aortic aneurysm patients who underwent OSR had a significantly lower incidence of dementia than those who underwent NST (adjusted HR=0.638, 95% confidence interval (CI)=0.411-0.764, p<0.001). Patients who underwent EVAR did not have a lower incidence of dementia than those who underwent NST.

Conclusion: OSR was associated with a reduced incidence of dementia in patients with aortic aneurysms compared to NST.

Keywords: Aortic aneurysm; Dementia; Endovascular repair; Open surgical repair.