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Risk of Dementia in Gastric Cancer Survivors Who Underwent Gastrectomy: A Nationwide Study in Korea

Yoon Jin Choi MD, PhD, Dong Wook Shin MD, Dr PH, MBA, Wooyoung Jang MD, Dong Ho Lee MD, PhD, Su-Min Jeong MD, Sanghyun Park MS, Kyung-do Han PhD, Yong Gyu Park PhD
Health Services Research and Global Oncology
Volume 26, Issue 13 / December , 2019

Abstract

Purpose

This study was designed to compare the risk of dementia, including Alzheimer’s disease (AD) and vascular dementia (VaD), between gastric cancer patients who underwent gastrectomy and the general population.

Methods

All patients (n = 63,998) aged ≥ 50 years who received a diagnosis of gastric cancer and underwent curative gastrectomy between 2007 and 2012 and a noncancer control population (n = 203,276), matched by age and sex, were identified from the Korean National Health Insurance Services and traced until 2017. Hazard ratios and 95% confidence intervals for dementia were calculated with a Cox regression analysis.

Results

Gastric cancer patients who received a gastrectomy showed an increased risk of AD [adjusted hazard ration (aHR) 1.08, 95% confidence interval (CI) 1.03–1.14], and the risk was especially marked for those who received a total gastrectomy (aHR 1.39, 95% CI 1.25–1.54). Gastric cancer survivors showed a decreased risk for VaD (aHR 0.85; 95% CI 0.73–0.98) regardless of operation type. Those who received continual vitamin B12 supplementation after a total gastrectomy were less likely than controls to develop AD (aHR 0.71; 95% CI 0.54–0.92).

Conclusions

Compared with controls, gastric cancer patients who received a total gastrectomy had an increased incidence of AD and a decreased risk of VaD. Our results suggest that vitamin B12 deficiency might play a role in the development of AD and highlight the need for vitamin B12 supplementation after total gastrectomy.

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