According to the researchers, their study was the first to explore IBD as a factor of dementia.
“In fact, we knew that 30% of people with IBD would develop these,” said Zhang. “However, it was not until recently that we began to see more neurocognitive changes and neurocognitive impairment.”
A longitudinal study
The study analyzed 1,742 patients with IBD who were 45 years or older, selected from the Research Database of the National Taiwan Health Insurance, and compared them to more than 17,400 people without the disease.
They were tracked for up to 16 years to examine the relationship between dementia and IBD. The study was observational and did not establish cause and effect. Nor did it analyze lifestyle factors such as diet and exercise.
Participants with IBD had a 4.1% higher incidence of dementia and were diagnosed more than seven years earlier than those patients without IBD. The overall incidence of dementia was 5.5% among patients with IBD compared to 1.4% among those without IBD.
The study found that the association between IBD and dementia was the same for men and women. There was no difference in risk. among those with ulcerative colitis or Crohn’s disease, but there was an increased risk of dementia as the severity and duration of IBD increased.
According to previous studies, IBD patients who are in remission and do not experience symptoms may still have remaining inflammation. Due to those previous findings, the authors believe that both inflammation during symptoms and inflammation during remission periods could contribute to the development of dementia.
The current study “added another piece of the puzzle in terms of the additional manifestations of IBD in the brain,” said Zhang.
The links between IBD and cognitive decline
Several other factors may also explain the association, said Dr. Aline Charabaty Pishvaian, director of the Center for Inflammatory Bowel Disease at Sibley Memorial Hospital in Washington, DC, who was not involved in the study.
Because IBD affects nutrient absorption through the intestines, patients may have nutritional deficiencies that affect brain health. People with IBD often have higher blood markers of inflammation; In fact, previous studies found that chronic disease patients with these markers were at increased risk for brain damage and dementia.
Lack of sleep and chronic stress, which affect IBD patients, can accelerate cognitive decline, Charabaty Pishvaian said.
“If we believe that chronic inflammation, nutrient deficiencies, and chronic physical and emotional stress are possible major factors promoting cognitive decline and dementia in our IBD patients,” he said, “it is even more crucial to control inflammation in the intestine”.
Any nutritional deficiencies must be corrected, said Charabaty Pishvaian, and mental and emotional health must be evaluated, to prevent not only gastrointestinal complications but also to improve overall health.
“This is a life-long disease that requires a comprehensive and multidisciplinary approach,” he added.