• Isr Med Assoc J · Jul 2023

    The Prevalence of Dementia among Dermatomyositis and Polymyositis Patients: A Retrospective Cohort Study.

    • Yonatan Shneor Patt, Niv Ben-Shabat, Lior Fisher, Howard Amital, Abdulla Watad, and Kassem Sharif.
    • Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel, Department of Internal Medicine B, Sheba Medical Center, Tel Hashomer, Israel, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
    • Isr Med Assoc J. 2023 Jul 1; 25 (7): 479484479-484.

    BackgroundPolymyositis (PM) and dermatomyositis (DM) are inflammatory mediated myopathies characterized by progressive symmetric proximal muscle weakness and associated with extra-muscular involvement. Central nervous system complications are rarely reported with these diseases.ObjectivesTo investigate the association between dementia and PM/DM.MethodsA retrospective cohort study was conducted using a database from Clalit Health Care, the largest health maintenance organization in Israel. Patients with a first recorded diagnosis of PM/DM were included and were compared with age- and sex-matched controls by a ratio of 1:5. The prevalence of dementia among PM/DM patients compared to controls was assessed using a univariate and a multivariable model. Binary logistic regression analysis was conducted to assess the association of different factors with dementia within the PM/DM cohort.ResultsThe study included 2085 PM/DM cases (17.0%) and 10,193 age- and sex-matched controls (83.0%). During the follow-up time, 36 PM/DM patients were diagnosed with dementia compared to 160 controls, with a univariate hazard ratio (HR) of 1.10 (95% confidence interval [95%CI] 0.77-1.58). Within the PM/DM cohort, significant predictors for the development of dementia included increased age at diagnosis (5 years increment; OR 1.86, 95%CI 1.57-2.21, P < 0.001) and treatment with glucocorticoids (OR 5.40, 95%CI 1.67-17.67, P = 0.005).ConclusionsIn our cohort, inflammatory myopathies were not associated with dementia. Age and treatment with glucocorticoids were associated with dementia. If dementia is diagnosed in patients with inflammatory myopathies, other systemic causes should be investigated.

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