The Risk of Alzheimer's Disease After Acute Appendicitis

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It is well known that approximately 10% cognitively healthy patients undergoing surgery will develop symptoms of cognitive dysfunction after their procedure but will recover quickly. A few percent of them will develop a Parkinson disease. It is known that persistent degree of cognitive impairment will appear in up to 10% of elderly patients up to three months after a surgical procedure. No large studies had studied the impact of surgery and anesthesia on Alzheimer disease.

There is some relation between Parkinson disease and the digestive system. Aggregated alpha synuclein is a pathologic feature of Parkinson’s disease. It has been found in the gastrointestinal tract early in the onset of the Parkinson’s disease. There has been conflicting reports on whether appendectomies increase the risk of Parkinson’s disease. The overall Relative Risk (RR) of developing Parkinson’s disease in patients after appendectomies is usually estimated at a few percent.

The aim of the current study by Chih-Sung Liang, Mu-Hong Chen of National Yang-Ming University, Taipei, was to examine the risk of Alzheimer's disease (AD) and other types of dementia following appendicitis or appendectomy for appendicitis.

The scientists used claims data from the Taiwan National Health Insurance Research Database. Participants aged ≥45 years with acute appendicitis or who received appendectomy for appendicitis were enrolled and followed up for more than 15 years.

Patients developing appendicitis and those receiving appendectomy for appendicitis had higher incidences of Alzheimer disease than the controls during the follow-up period. A Cox regression analysis showed that those patients were more likely to develop Alzheimer disease than the controls.

These patients also had higher risks all types of dementia (but not vascular dementia which is often associated with aging) than the controls. The age at dementia diagnosis was 88.51 years in the controls; however, among people who developed dementia following appendicitis, the mean age at diagnosis was 70.18 years, and dementia occurred 5.84 years after appendicitis.

Alzheimer's disease has a multifactorial etiology. Diet, cardiovascular disease, low grade systemic inflammation have been associated with it. All of these factors have some relationship with the gastrointestinal tract.


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