炎症性腸疾患が認知症の進行を加速する可能性(Inflammatory bowel disease possibly accelerates dementia)

2025-07-23

2025-07-22 カロリンスカ研究所(KI)

スウェーデンのカロリンスカ研究所の研究により、炎症性腸疾患(IBD)が認知症患者の認知機能低下を加速させる可能性が示された。スウェーデンの認知症登録データ(SveDem)を用い、認知症後にIBDを発症した111名と、IBDを持たない1,110名を比較。MMSEスコアに基づく認知機能の変化を追跡した結果、IBD併発群では年1点近く多くスコアが低下し、その進行はIBD診断後により顕著だった。これは新薬ドナネマブの効果に匹敵する臨床的意義を持つ。因果関係の証明やIBD重症度の情報には限界があるが、IBDの治療が認知機能低下を抑制できる可能性があり、個別化医療の重要性が示唆される。

<関連情報>

炎症性腸疾患は認知症患者の認知機能低下を促進する:全国コホート研究
Inflammatory bowel disease linked to accelerated cognitive decline in individuals with dementia: a nationwide cohort study

Minjia Mo,Jiangwei Sun,Iris Mikulic,Jonas F Ludvigsson,Sara Garcia-Ptacek,Maria Eriksdotter,Hong Xu
Gut Published July 11, 2025
DOI:https://doi.org/10.1136/gutjnl-2025-335370

A recent study by Erkert et al identified a new role for Alzheimer’s disease (AD)-associated presenilins as key molecules involved in maintaining intestinal epithelial function, barrier integrity and immune homeostasis, linking AD and inflammatory bowel disease (IBD) at the molecular level.1 2 Meanwhile, Zhang et al, from an epidemiological perspective, reported that individuals with IBD have a higher risk of developing dementia, particularly AD.3 The ‘gut-brain axis’, which links the intestine and the central nervous system (CNS), has received significant attention in recent years.

IBD may impact brain function by triggering systemic inflammation, disrupting neuronal regulation and altering interactions between the gut microbiota and the CNS, potentially leading to dementia.4 5 However, whether IBD accelerates cognitive decline in dementia remains unclear. Dementia is an irreversible disease that worsens over time.6 Since dementia is currently incurable, slowing cognitive decline and understanding its mechanisms are crucial for improving the lives and healthcare support for affected individuals.7

We conducted a propensity score-matched cohort study to investigate the association between IBD and the progression of dementia, as measured by Mini-Mental State Examination (MMSE) scores. Using the Swedish Registry for Cognitive/Dementia Disorders (SveDem) and the Swedish National Patient Register, we identified individuals with dementia and incident IBD from 2007 to 2018. For each individual with dementia with later IBD, we matched 10 individuals with dementia without IBD using the nearest matching method and a calliper of 0.1 to balance confounders between the two groups. We defined …