Risk of Dementia in Different Types of Cancer Survivors: A Nationwide Cohort Study

Objectives: The association between specific types of malignancies and the subsequent risk of dementia remains unknown. Design: A retrospective population-based cohort study based on data from Taiwan National Health Insurance Research Database. Setting and participants: We recruited 32,250 patients who survived malignancies and 322,500 controls between 1998 and 2011 and followed them up until the end of 2013. Measurements: Diagnoses of dementia (including Alzheimer's disease (AD), vascular dementia (VaD), and unspecified dementia) was made during the follow-up period. Cox regression analyses were performed after adjusting for potential confounders. A sensitivity analysis was conducted to exclude patients with prodromal dementia. Results: Cancer survivors were more likely to develop AD (hazard ratio [HR]:1.68, 95% confidence interval [CI]: 1.38-2.06), unspecified dementia (HR:1.19, 95% CI: 1.07 -1.32), and any dementia (HR:1.26, 95% CI: 1.16-1.37) compared with controls after adjusting for potential confounders. Importantly, cancers of the digestive and genitourinary organs seem to be associated with AD, unspecified dementia, and any dementia, whereas only malignant neoplasms of the brain