Risk of cognitive disorders in patients with primary Sjögren's disease: data from Korean Health Insurance Service.

OBJECTIVE

To investigate the risk of incident cognitive disorders in patients with primary Sjögren's disease (pSjD) using nationwide Korean National Health Insurance Service data.

METHODS

This retrospective cohort study included patients newly diagnosed with pSjD between 2010 and 2021 and propensity score-matched controls. The primary outcome was a composite of Alzheimer's dementia (AD), vascular dementia (VaD), secondary dementia, unclassified dementia and mild cognitive impairment (MCI). Adjusted HRs (aHRs) and 95% CIs were estimated using multivariable Cox regression. Age-stratified analyses were also performed.

RESULTS

A total of 12 731 patients with pSjD and 36 514 matched controls were analysed. pSjD was associated with increased risks of total cognitive disorders (aHR 1.48, 95% CI 1.36 to 1.63), AD (aHR 1.48, 95% CI 1.35 to 1.63), secondary dementia (aHR 2.24, 95% CI 1.45 to 3.48), unclassified dementia (aHR 1.43, 95% CI 1.21 to 1.70) and MCI (aHR 1.62, 95% CI 1.41 to 1.85). In age-stratified analyses, pSjD was associated with an increased risk of MCI among participants aged <65 years (aHR 1.46, 95% CI 1.06 to 2.01). Among those aged 65-74 years, pSjD was associated with increased risks of total cognitive disorders, AD and MCI.

CONCLUSIONS

pSjD was associated with increased risks of multiple cognitive disorders. The age-specific patterns-an increased risk of MCI among individuals aged <65 years and increased risks of total cognitive disorders, AD and MCI among those aged 65-74 years-underscore the need for clinical attention to cognitive symptoms across age groups in patients with pSjD.