Introduction

Epidemiological and genetic studies have reported a link between antecedent ADHD and dementia. The underpinning mechanisms of these associations are not known and have generated considerable speculation.

Methods

We have extracted hospitalization discharge data on dementia and ADHD (representing a severe phenotype) from the Healthcare Cost and Utilization Project (HCUPnet) and utilized a Poisson regression with two-ways fixed effects to investigate this association.

Results

An unadjusted ten-year lagged measure of a severe ADHD phenotype increases hospitalization risk for an all-listed Lewy Body Dementia (LBD) diagnosis (IRR: 1.21, 95% C.I. 1.08–1.35) and Alzheimer's disease (AD) discharge diagnosis (IRR: 1.15, 95% C.I.: 1.05–1.27). However, these relationships may be dependent upon the extent of metabolic dysregulation in a subtype-specific manner, as controlling for diabetes removes the significant association between antecedent ADHD and risk of AD but not LBD.

Discussion

These results indicate that the association between antecedent ADHD and dementia risk may be uniquely influenced by metabolic dysregulation, building upon prior discussion in this journal of a purported link between AD and diabetes. We tie the current findings to environmental risk factors that we have previously implicated in the etiology of ADHD to generate testable hypotheses on the underlying brain neurochemistry that may facilitate the link between metabolic dysregulation and dementia subtype risk.

中文翻译：

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前期多动症，痴呆和代谢失调：基于美国的队列分析

介绍

流行病学和遗传学研究报告了多动症与痴呆之间的联系。这些协会的基础机制尚不清楚，并且已经引起了很大的猜测。

方法

我们从医疗保健成本和利用项目（HCUPnet）中提取了痴呆和ADHD（代表严重表型）的住院出院数据，并利用具有双向固定效应的Poisson回归来研究这种关联。

结果

未经校正的严重多动症表型的十年滞后量度会增加所有列出的路易体痴呆（LBD）诊断（IRR：1.21，95％CI 1.08–1.35）和阿尔茨海默病（AD）出院诊断（IRR： 1.15，95％CI：1.05-1.27）。但是，这些关系可能以亚型特异性方式取决于代谢失调的程度，因为控制糖尿病消除了先前的ADHD与AD风险之间的显着关联，而与LBD无关。

讨论

这些结果表明，在本杂志先前关于AD与糖尿病之间的联系的先前讨论的基础上，新陈代谢异常调节可能会独特地影响代谢异常所造成的ADHD与痴呆风险之间的关联性。我们将当前的发现与我们先前与多动症的病因有关的环境风险因素联系起来，以在潜在的大脑神经化学上产生可检验的假设，从而可能促进代谢失调与痴呆亚型风险之间的联系。