Intravesical BCG and Incidence of Alzheimer Disease in Patients With Bladder Cancer: Results From an Administrative Dataset

Alzheimer Dis Assoc Disord. 2022 Oct-Dec;36(4):307-311. doi: 10.1097/WAD.0000000000000530. Epub 2022 Sep 30.

Abstract

Introduction: Alzheimer disease (AD) is a common neurodegenerative disease, and immunomodulation offers treatment opportunities. Preclinical data suggest that intravesical Bacillus Calmette-Guerin (BCG) treatment could delay AD development. We investigated this relationship in a population-based cancer database.

Sample and methods: We queried the Surveillance, Epidemiology, and End Results-Medicare database for patients with high-risk nonmuscle-invasive bladder cancer (hrNMIBC). BCG dosage and subsequent Alzheimer diagnosis were collected through ICD-9/10 codes. Multivariable Cox regression was performed to assess the association between BCG therapy and subsequent Alzheimer diagnosis.

Results: We identified 26,584 hrNMIBC patients; 51% received BCG and 8.3% were diagnosed with Alzheimer. BCG exposure was significantly associated with lower Alzheimer occurrence (hazard ratio: 0.73, P <0.05), which was dose-dependent. Increasing age, female sex, Black race, and increasing comorbidity index were significantly associated with a greater risk of subsequent Alzheimer diagnosis.

Discussion: Treatment with intravesical BCG among patients with hrNMIBC was associated with a significantly lower risk for subsequent Alzheimer diagnosis, which seemed dose-dependent.

MeSH terms

  • Aged
  • Alzheimer Disease* / epidemiology
  • BCG Vaccine / therapeutic use
  • Female
  • Humans
  • Incidence
  • Medicare
  • Neoplasm Invasiveness
  • Neoplasm Recurrence, Local / therapy
  • Neurodegenerative Diseases*
  • United States / epidemiology
  • Urinary Bladder Neoplasms* / drug therapy
  • Urinary Bladder Neoplasms* / epidemiology

Substances

  • BCG Vaccine