Risk of Suicide in Association with Major Depressive Disorder among Patients with Dementia: A Population-based Nested Case-Control Study.

OBJECTIVE: This study aimed to explore the association between major depressive disorder (MDD) and suicide risk in dementia patients. METHODS: A cohort of 625,218 individuals aged ≥40 years with dementia between 2007 and 2018 was identified from Taiwan's National Health Insurance Research Database. After excluding prevalent cases in 2007. Subsequently, a nested case-control study enrolled 1,256 suicide cases and 5,022 matched controls was conducted. The frequencies of MDD-related outpatient or inpatient visits over a 7-year period preceding the event dates were calculated and analyzed for association using conditional logistic regression. RESULTS: Dementia comorbid with MDD was associated with increased suicide risk (adjusted odds ratio [AOR]: 2.67), particularly in individuals with ≤1.0 MDD episodes per year (AOR: 2.85). Similar association was observed only in individuals aged ≥65 years and males, with a pronounced risk of suicide in those ≤1.0 MDD episodes per year (AOR: 3.08 for individuals aged ≥65 years; AOR: 3.28 for males). Conversely, the risk increase was evident with >1.0 MDD episodes per year in those aged <65 years (AOR: 3.04) and females (AOR: 2.45). CONCLUSIONS: MDD is associated with suicide risk in dementia patients, with the strength of this association possibly varying by age and gender.

Vitamin E Status Is Inversely Associated with Risk of Incident Tuberculosis Disease among Household Contacts.

Background: Few studies have previously assessed how pre-existing vitamin E status is associated with risk of tuberculosis (TB) disease progression. Objective: We evaluated the association between baseline plasma concentrations of 3 vitamin E isomers (α-tocopherol, γ-tocopherol, and δ-tocopherol) and TB disease risk. Methods: We conducted a case-control study nested within a longitudinal cohort of household contacts (HHCs) of pulmonary TB cases in Lima, Peru. We defined cases as HHCs who developed active TB disease ≥15 d after the diagnosis of the index patient, and we matched each case to 4 control cases who did not develop active TB based on age by year and gender. We used univariate and multivariate conditional logistic regression to calculate ORs for incident TB disease by plasma concentrations of α-tocopherol, γ-tocopherol, and δ-tocopherol. Results: Among 6751 HIV-negative HHCs who provided baseline blood samples, 180 developed secondary TB during follow-up. After controlling for possible confounders, we found that baseline α-tocopherol deficiency conferred increased risk of incident TB disease (adjusted OR: 1.59; 95% CI: 1.02, 2.50; P = 0.04). Household contacts in the lowest tertile of δ-tocopherol were also at increased risk of progression to TB disease compared to those in the highest tertile (tertile 1 compared with tertile 3, adjusted OR: 2.29; 95% CI: 1.29, 4.09; P-trend = 0.005). We found no association between baseline concentration of γ-tocopherol and incident TB disease. Conclusions: Vitamin E deficiency was associated with an increased risk of progression to TB disease among HHCs of index TB cases. Assessment of vitamin E status among individuals at high risk for TB disease may play a role in TB control efforts.