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INTRODUCTION

The Global Burden of Disease Study has ranked dementia the 5th common chronic disease.¹ The Institute for Health Metrics and Evaluation (IHME) has estimated that there was a 112.8% increase in the disability-adjusted life-year cost for dementia in 2010 compared that in 1990. It was anticipated that the cost would increase further for more than 80% by 2030.¹ The Alzheimer Disease International (ADI) Report has also estimated that approximately 44.4 million people were affected by dementia in 2010, and this number would increase to 75.6 million by 2030 and 135.5 million by 2050. In 2010, the Global total social costs for dementia were estimated to be US $ 604 billion, corresponding to 1.0% of the global GDP.^2–4Dementia is more important than Alzheimer disease alone in causing a huge economic burden.^5–7Dementia is the brain disease characterized by impaired memory and loss of thinking and reasoning, which severely affect the patient’s daily functioning.⁸

The risk of developing dementia has been associated with several conditions, including alcohol abuse (alcohol-related dementia), chronic traumatic encephalopathy, drug side effects, depression, and other central nervous system disorders.^9–15 Establishing a link between associated risk factors and dementia may provide appropriate means of treatment and counseling, thereby reducing the risk of dementia and costs of treatment.

Carbon monoxide (CO) poisoning is a common and important cause of death among populations, including populations in the United States, and England and Wales.¹⁶ Approximately 15,000 unintentional nonfire related episodes of CO poisoning have been reported annually in England and Wales, leading to 50,000 emergency department visits and 500 deaths.¹⁷ The memory difficulty and confusion are initial neurological symptoms of acute CO poisoning in addition to headache, weakness, dizziness, nausea, and vomiting.¹⁵ Furthermore, unconsciousness, respiratory arrest, and even death could develop for the CO poisoning victims.¹⁷ Previous studies have reported that up to 30% of patients result in the sequelae of neurologic complications after the poisoning.^18,19 Intellectual function impairments, short-term memory loss, dementia, amnesia, psychosis, irritability, dysfunctional gait, speech disorders, Parkinson disease-like syndrome, cortical blindness, and depression are among the poisoning sequelae.^20,21 Victims of CO poisoning may suffer from brain hypoxia, inflammation, and subsequent injuries.²² Patients with ischemia-reperfusion injury exposing to high oxygen may aggravate the oxidative damage after recovery from CO poisoning.^23,24 Encephalopathy and other neuropsychiatric disorders are other sequelae in victims. It remains unclear whether such abnormalities increase the risk of dementia.^25–28 In an earlier Japanese study, Mimura et al²⁸ found considerable sequelae in CO poisoning patients after follow-up for 33 years. No large-scale long-term follow-up study has ever evaluated this relationship. The present study was conducted to evaluate whether patients with CO poisoning are at an elevated risk of developing dementia.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4706265/