Risk of Dementia in Individuals With Emergency Department Visits or Hospitalizations Due to Cannabis
Notice bibliographique
Résumé
Importance: Cannabis use is associated with short-term memory impairment and long-term changes in brain structure; however, little is known about whether disordered cannabis use is associated with an increased risk of a dementia diagnosis. Objective: To investigate the association between emergency department visits or hospitalizations (acute care encounters) due to cannabis and future dementia diagnosis. Design, Setting, and Participants: Population-based, retrospective, matched cohort study using health administrative data from Ontario, Canada, between 2008 and 2021 (with follow-up until 2022) including all individuals aged 45 to 105 years living in Ontario who were eligible and did not have a diagnosis of dementia at cohort entry (2 620 083 individuals excluded). Exposure: Individuals with incident acute care due to cannabis use, defined using International Classification of Diseases and Related Health Problems, Tenth Revision coding. Main Outcomes and Measures: We used cause-specific adjusted hazard models to compare new diagnoses of dementia (from a validated algorithm) between individuals with acute care due to cannabis use with (1) individuals with all-cause acute care (excluding cannabis), (2) the general population, and (3) individuals with acute care due to alcohol use. Results: The study included 6 086 794 individuals, of whom 16 275 (0.3%) had incident acute care due to cannabis use (mean age, 55.2 [SD, 8.3] years; 60.3% male). Annual rates of incident acute care due to cannabis use increased 5.0-fold in individuals aged 45 to 64 years (from 10.16 to 50.65 per 100 000) and 26.7-fold in individuals aged 65 years or older (from 0.65 to 16.99 per 100 000) between 2008 and 2021. Individuals with incident acute care due to cannabis use were at a 1.5-fold and 3.9-fold increased risk of dementia diagnosis within 5 years relative to individuals with all-cause acute care and the general population of the same age and sex, respectively (absolute rates of dementia diagnosis: 5.0% for cannabis-related acute care, 3.6% for all-cause acute care, and 1.3% in the general population). After adjustment for sociodemographics and chronic health conditions, individuals with acute care due to cannabis use remained at elevated risk relative to those with all-cause acute care (adjusted hazard ratio [aHR], 1.23; 95% CI, 1.09-1.39) and the general population (aHR, 1.72; 95% CI, 1.38-2.15). Individuals with acute care due to cannabis use were at lower risk than those with acute care due to alcohol use (aHR, 0.69; 95% CI, 0.62-0.76). Conclusions and Relevance: Individuals with cannabis use severe enough to require hospital-based care were at increased risk of a new dementia diagnosis compared with those with all-cause hospital-based care or the general population. These findings have important implications considering increasing cannabis use among older adults.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».