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Increased risk of dementia in patients with primary Sjogren’s syndrome: a nationwide population-based cohort study
Kyung‐Ann Lee, Hyeji Jeon, Hyun-Sook Kim, Kyomin Choi, Gi Hyeon Seo. The Korean Journal of Internal Medicine, 2025-02-21
Topic: Risk, prevention and care in population studies
The incidence of dementia was 0.68 (95% CI 0.64-0.72) cases per 100 person-years in pSS, and it was 0.58 (0.56-0.60) in the controls. The adjusted HR (aHR) of developing dementia was 1.16 (1.09-1.25) times greater in the pSS group than in the controls. The risk of dementia did not increase in HCQ users (aHR 1.07 [0.94-1.21]), but HCQ non-users had a 1.22 (1.12-1.33) higher risk of developing dementia than the matched controls. The use of HCQ lowered the risk of dementia in comparison with non-users in patients with pSS (aHR 0.82 [0.71-0.94]). Our results suggest that pSS is associated with an increased risk of dementia. HCQ may prevent dementia in patients with pSS.
Key findings
- The incidence of dementia was 0.68 (95% CI 0.64-0.72) cases per 100 person-years in pSS, and it was 0.58 (0.56-0.60) in the controls.
- The adjusted HR (aHR) of developing dementia was 1.16 (1.09-1.25) times greater in the pSS group than in the controls.
- The risk of dementia did not increase in HCQ users (aHR 1.07 [0.94-1.21]), but HCQ non-users had a 1.22 (1.12-1.33) higher risk of developing dementia than the matched controls.
- The use of HCQ lowered the risk of dementia in comparison with non-users in patients with pSS (aHR 0.82 [0.71-0.94]).
- Our results suggest that pSS is associated with an increased risk of dementia.
Why it matters
People with primary Sjögren's syndrome had a higher risk of developing dementia than controls, and those taking hydroxychloroquine had a lower risk than non-users. The authors suggest hydroxychloroquine may prevent dementia in these patients, but this was an observational cohort study and not a trial.
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Study details
- Study designcohort study
- Participants20,160
- Effect sizeaHR 1.07; aHR 0.82
- Evidence strengthModerate
How this study scored 55/100
Published in a peer-reviewed journal, and it is a cohort study following people over time. Scored zero for randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (The Korean Journal of Internal Medicine) |
| Journal's citation record | 0 / 4 | The Korean Journal of Internal Medicine: journal h-index 74 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 4 / 4 | 20,160 participants |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 2 / 7 | Cited 5 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 1.7 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 2 / 6 | Cited 2.7× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 1 / 4 | Cited 5 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Gi Hyeon Seo: h-index 21 (OpenAlex, whole career) |
| Institution's track record | 0 / 3 | Soonchunhyang University: institution h-index 265 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 39987901) |
| Free to read | 2 / 2 | Free to read |
| Total | 55 / 100 | — |
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Read the original
- DOI: 10.3904/kjim.2023.536
- PubMed: 39987901
- Original source →
- Free full text: The Korean Journal of Internal Medicine →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Lee, K., Jeon, H., Kim, H.-S., Choi, K., & Seo, G. H. (2025). Increased risk of dementia in patients with primary Sjogren’s syndrome: a nationwide population-based cohort study. The Korean Journal of Internal Medicine. https://doi.org/10.3904/kjim.2023.536
Vancouver
Lee K, Jeon H, Kim H.-S, Choi K, Seo GH. Increased risk of dementia in patients with primary Sjogren’s syndrome: a nationwide population-based cohort study. The Korean Journal of Internal Medicine. 2025. doi:10.3904/kjim.2023.536. PMID: 39987901.
BibTeX
@article{lee2025-39987901,
author = {Lee, Kyung‐Ann and Jeon, Hyeji and Kim, Hyun-Sook and Choi, Kyomin and Seo, Gi Hyeon},
title = {{Increased risk of dementia in patients with primary Sjogren’s syndrome: a nationwide population-based cohort study}},
journal = {The Korean Journal of Internal Medicine},
year = {2025},
doi = {10.3904/kjim.2023.536},
pmid = {39987901},
url = {https://doi.org/10.3904/kjim.2023.536}
}
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