Risk of Dementia in Patients with Insomnia and Long-term Use of Hypnotics A Population-based Retrospective Cohort Study 英文参考文献.docVIP

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Risk of Dementia in Patients with Insomnia and Long-term Use of Hypnotics A Population-based Retrospective Cohort Study 英文参考文献.doc

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Risk of Dementia in Patients with Insomnia and Long-term Use of Hypnotics A Population-based Retrospective Cohort Study 英文参考文献

RiskofDementiainPatientswithInsomniaandLong- termUseofHypnotics:APopulation-based RetrospectiveCohortStudy Pin-LiangChen1.,Wei-JuLee2,3,4.,Wei-ZenSun5,Yen-JenOyang1,7,Jong-LingFuh3,6 * 1Department of Computer Science and Information Engineering, National Taiwan University, Taipei, Taiwan, 2Department of Neurology, Taichung Veterans General Hospital,Taichung,Taiwan,3FacultyofMedicine,NationalYang-MingUniversitySchoolofMedicine,Taipei,Taiwan,4InstituteofClinicalMedicine,NationalYang-Ming University,Taipei,Taiwan,5DepartmentofAnesthesiology,NationalTaiwanUniversityHospital,Taipei,Taiwan,6DepartmentofNeurology,NeurologicalInstitute,Taipei VeteransGeneralHospital,Taipei,Taiwan,7GraduateInstitutesofBiomedicalElectronicsandBioinformatics,NationalTaiwanUniversity,Taipei,Taiwan Abstract Background:Hypnoticshavebeenreportedtobeassociatedwithdementia.However,therelationshipbetweeninsomnia, hypnotics and dementia is still controversial. We sought to examine the risk of dementia in patients with long-term insomniaandthecontributionofhypnotics. Methods: Data was collected from Taiwan’s Longitudinal Health Insurance Database. The study cohort comprised all patientsaged50yearsorolderwithafirstdiagnosisofinsomniafrom2002to2007.Thecomparisoncohortconsistedof randomly selected patients matched by age and gender. Each patient was individually tracked for 3 years from their insomniaindexdatetoidentifywhetherthepatienthadafirstdiagnosisofdementia.Coxregressionwasusedtoestimate hazardratios(HRs)and95%confidenceintervals(CIs). Results: We identified 5693 subjects with long-term insomnia and 28,465 individuals without. After adjusting for hypertension,diabetesmellitus,hyperlipidemia,andstroke,thosewithlong-terminsomniahadsignificantlyhigherrisksof dementia(HR,2.34;95%CI,1.92–2.85).Patientswithlong-terminsomniaandaged50to65yearshadahigherincreasedrisk ofdementia(HR,5.22;95%CI,2.62–10.41)thanthoseolderthan65years(HR,2.33;95%CI,1.90–2.88).Theuseofhypnotics withalongerhalf-lifeandatahigherpre