Pneumoconiosis and the subsequent risk of dementia: a retrospective cohort study

Abstract Background Pneumoconiosis has been recognized as a risk factor for systemic diseases; however, its association with dementia remains unclear. This study aims to investigate the association of pneumoconiosis with the subsequent risk of dementia. Methods This retrospective cohort study used data from Taiwan’s National Health Insurance database. The pneumoconiosis cohort included 17 871 patients diagnosed with pneumoconiosis from 2009 to 2020. A comparison cohort of 71 484 individuals without pneumoconiosis was matched in a 1:4 ratio in terms of age, sex, and diagnostic date. All study participants were followed up until the end of 2020 to evaluate dementia incidence. Results The incidence of dementia in the pneumoconiosis cohort was 17.6 per 1000 person-years, which was significantly higher than the 12.3 per 1000 person-years in the control group. Age-stratified analysis revealed that patients aged 65–74 years (aHR = 1.26, 95% CI = 1.15–1.38) and ≥75 years (aHR = 1.49, 95% CI = 1.38–1.60) demonstrated a significantly increased risk. Sex-specific analysis revealed that both men (aHR = 1.39, 95% CI = 1.31–1.48) and women (aHR = 1.30, 95% CI = 1.11–1.51) exhibited a significantly increased risk. Further, the frequency of emergency department visits among patients with pneumoconiosis was positively associated with dementia risk. Conclusion Utilizing a large-scale medical database, this study reveals that patients with pneumoconiosis demonstrated a significantly increased risk of developing dementia. Early cognitive function screening is recommended for this population to reduce disability and improve long-term outcomes. Key messages What is already known on this topic: Pneumoconiosis has considerable comorbidities, particularly pulmonary and cardiovascular diseases. However, the association between pneumoconiosis and dementia is largely unknown. What this study adds: The nationwide, population-based, retrospective cohort study revealed that patients with pneumoconiosis had a significantly higher risk of dementia than those without pneumoconiosis. How this study might affect research, practice, or policy: Greater emphasis on early cognitive function screening in this population may help to reduce disability rates and enhance long-term outcomes.