N-Acetylcysteine and Dementia Risk in Elderly Patients.

IF 2.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry Pub Date : 2026-04-01 DOI:10.1002/gps.70212

Mingyang Sun, Zhongyuan Lu, Wan-Ming Chen, Shuang Lv, Ningning Fu, Yitian Yang, Yangyang Wang, Mengrong Miao, Szu-Yuan Wu, Jiaqiang Zhang

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引用次数: 0

Abstract

Objective: This study aimed to investigate the association between N-acetylcysteine (NAC) use and dementia risk in elderly individuals diagnosed with Chronic Obstructive Pulmonary Disease (COPD).

Methods: Utilizing Taiwan's National Health Insurance Research Database (NHIRD), we conducted a population-based cohort study of 105,144 elderly COPD patients to investigate the association between NAC use and dementia risk. Propensity score matching (PSM) ensured balanced covariates between NAC users and nonusers. Cox regression analysis and Poisson Regression analysis were employed to assess dementia risk, considering NAC dosage, treatment duration, and comorbidities. Competing risk analysis and Kaplan-Meier method were used to account for mortality risk and estimate dementia incidence, respectively.

Results: Elderly NAC users demonstrated a significant association with a lower dementia risk (adjusted hazard ratio [aHR]: 0.76, 95% confidence interval [CI]: 0.74-0.78). Higher daily NAC intake was associated with a dose-dependent decline in dementia risk, with optimal benefits observed at an average daily dose of 1.61 defined daily doses (DDD). Stratification by cumulative defined daily doses (cDDD) of NAC revealed a consistent dose-response relationship, with progressively diminished dementia risk across quartiles of cDDD. Notably, NAC use was associated with a lower risk of Alzheimer's dementia (aHR: 0.68, 95% CI: 0.66-0.70) compared to non-NAC antimucolytic users.

Conclusions: NAC use is associated with a dose-dependent reduction in dementia risk among elderly COPD patients, particularly for Alzheimer's dementia. Our findings underscore the potential of NAC as a potential protective factor against dementia in this vulnerable population, warranting further investigation and consideration in clinical practice.

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老年患者的n -乙酰半胱氨酸与痴呆风险。

目的：本研究旨在探讨慢性阻塞性肺疾病（COPD）老年人n -乙酰半胱氨酸（NAC）使用与痴呆风险之间的关系。倾向评分匹配（PSM）确保NAC用户和非用户之间的协变量平衡。考虑NAC剂量、治疗时间和合并症，采用Cox回归分析和泊松回归分析评估痴呆风险。竞争风险分析和Kaplan-Meier方法分别用于解释死亡风险和估计痴呆发病率。结果：老年NAC使用者与较低的痴呆风险显著相关（校正风险比[aHR]: 0.76, 95%可信区间[CI]: 0.74-0.78）。较高的每日NAC摄入量与痴呆风险的剂量依赖性下降有关，在平均每日剂量为1.61定义日剂量（DDD）时观察到最佳益处。NAC的累积定义日剂量（cDDD）分层显示出一致的剂量-反应关系，在cDDD的四分位数中，痴呆风险逐渐降低。值得注意的是，与非NAC抗多溶剂使用者相比，NAC的使用与阿尔茨海默氏痴呆症的风险较低相关（aHR: 0.68, 95% CI: 0.66-0.70）。结论：在老年COPD患者中，NAC的使用与痴呆风险的剂量依赖性降低有关，特别是对于阿尔茨海默氏痴呆症。我们的研究结果强调了NAC在这一脆弱人群中作为一种潜在的预防痴呆症的保护因素的潜力，值得在临床实践中进一步研究和考虑。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Geriatric Psychiatry 医学-精神病学

CiteScore

6.10

自引率

2.50%

发文量

168

审稿时长

4-8 weeks

期刊介绍： The rapidly increasing world population of aged people has led to a growing need to focus attention on the problems of mental disorder in late life. The aim of the Journal is to communicate the results of original research in the causes, treatment and care of all forms of mental disorder which affect the elderly. The Journal is of interest to psychiatrists, psychologists, social scientists, nurses and others engaged in therapeutic professions, together with general neurobiological researchers. The Journal provides an international perspective on the important issue of geriatric psychiatry, and contributions are published from countries throughout the world. Topics covered include epidemiology of mental disorders in old age, clinical aetiological research, post-mortem pathological and neurochemical studies, treatment trials and evaluation of geriatric psychiatry services.