The Association Between Traumatic Brain Injury and the Risk of Cognitive Decline: An Umbrella Systematic Review and Meta-Analysis
Background: There is currently increasing interest in the implication of traumatic brain injury (TBI) as a potential risk factor for long-term neurodegenerative conditions, such as dementia and Alzheimer’s disease (AD). In this context, we performed a systematic review and meta-analysis to evaluate...
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2024-11-01
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| author | Ioannis Mavroudis Dimitrios Kazis Foivos Efstratios Petridis Ioana-Miruna Balmus Vasileios Papaliagkas Alin Ciobica |
| author_facet | Ioannis Mavroudis Dimitrios Kazis Foivos Efstratios Petridis Ioana-Miruna Balmus Vasileios Papaliagkas Alin Ciobica |
| author_sort | Ioannis Mavroudis |
| collection | DOAJ |
| description | Background: There is currently increasing interest in the implication of traumatic brain injury (TBI) as a potential risk factor for long-term neurodegenerative conditions, such as dementia and Alzheimer’s disease (AD). In this context, we performed a systematic review and meta-analysis to evaluate the association between TBI and the risk of dementia. Methods: A systematic search was performed across multiple electronic databases, including PubMed, Embase, and Cochrane Library, to identify relevant meta-analyses and cohort studies. Studies were included if they reported effect sizes (odds ratios [ORs] or relative risks [RRs]) for the association between TBI, its severity, and the risk of dementia or AD. Meta-analyses were performed using random-effects models to account for heterogeneity, and sensitivity analyses were conducted. Results: A total of six studies were included in the analysis. The pooled results showed that TBI significantly increases the risk of dementia, with an overall odds ratio of 1.81 (95% CI: 1.53–2.14). Mild TBI was associated with a modest increase in dementia risk (OR = 1.96, 95% CI: 1.70–2.26), while moderate-to-severe TBI showed a stronger association (OR = 1.95, 95% CI: 1.55–2.45). In contrast, the association between TBI and AD was less consistent, with the pooled OR for AD being 1.18 (at 95% CI: 1.11–1.25) for mild TBI; however, in several studies, no significant association was observed (OR = 1.02, 95% CI: 0.91–1.15). The results also indicated substantial heterogeneity across studies, particularly in relation to AD outcomes. Conclusions: The findings from this umbrella meta-analysis confirm that TBI is a significant risk factor for dementia, with more severe TBIs conferring a higher risk. While mild TBIs also increase the risk of dementia, the effect is more pronounced in moderate-to-severe injuries. The evidence linking TBI to AD is less robust, with inconsistent findings across studies. Clinicians should consider long-term cognitive screening and management for individuals with a history of TBI, particularly those with moderate-to-severe injuries. |
| format | Article |
| id | doaj-art-b7d89b881b6d4c93a56e13ba453f2bcd |
| institution | DOAJ |
| issn | 2076-3425 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | MDPI AG |
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| series | Brain Sciences |
| spelling | doaj-art-b7d89b881b6d4c93a56e13ba453f2bcd2025-08-20T02:56:06ZengMDPI AGBrain Sciences2076-34252024-11-011412118810.3390/brainsci14121188The Association Between Traumatic Brain Injury and the Risk of Cognitive Decline: An Umbrella Systematic Review and Meta-AnalysisIoannis Mavroudis0Dimitrios Kazis1Foivos Efstratios Petridis2Ioana-Miruna Balmus3Vasileios Papaliagkas4Alin Ciobica5Department of Neurosciences, Leeds Teaching Hospitals, NHS Trust, Leeds LS97TF, UKThird Department of Neurology, Aristotle University of Thessaloniki, 541 24 Thessaloniki, GreeceThird Department of Neurology, Aristotle University of Thessaloniki, 541 24 Thessaloniki, GreeceDepartment of Exact Sciences and Natural Sciences, Institute of Interdisciplinary Research, “Alexandru Ioan Cuza” University of Iasi, 700057 Iasi, RomaniaDepartment of Biomedical Sciences, International University of Thessaloniki, 570 01 Thessaloniki, GreeceAcademy of Romanian Scientists, 050094 Bucharest, RomaniaBackground: There is currently increasing interest in the implication of traumatic brain injury (TBI) as a potential risk factor for long-term neurodegenerative conditions, such as dementia and Alzheimer’s disease (AD). In this context, we performed a systematic review and meta-analysis to evaluate the association between TBI and the risk of dementia. Methods: A systematic search was performed across multiple electronic databases, including PubMed, Embase, and Cochrane Library, to identify relevant meta-analyses and cohort studies. Studies were included if they reported effect sizes (odds ratios [ORs] or relative risks [RRs]) for the association between TBI, its severity, and the risk of dementia or AD. Meta-analyses were performed using random-effects models to account for heterogeneity, and sensitivity analyses were conducted. Results: A total of six studies were included in the analysis. The pooled results showed that TBI significantly increases the risk of dementia, with an overall odds ratio of 1.81 (95% CI: 1.53–2.14). Mild TBI was associated with a modest increase in dementia risk (OR = 1.96, 95% CI: 1.70–2.26), while moderate-to-severe TBI showed a stronger association (OR = 1.95, 95% CI: 1.55–2.45). In contrast, the association between TBI and AD was less consistent, with the pooled OR for AD being 1.18 (at 95% CI: 1.11–1.25) for mild TBI; however, in several studies, no significant association was observed (OR = 1.02, 95% CI: 0.91–1.15). The results also indicated substantial heterogeneity across studies, particularly in relation to AD outcomes. Conclusions: The findings from this umbrella meta-analysis confirm that TBI is a significant risk factor for dementia, with more severe TBIs conferring a higher risk. While mild TBIs also increase the risk of dementia, the effect is more pronounced in moderate-to-severe injuries. The evidence linking TBI to AD is less robust, with inconsistent findings across studies. Clinicians should consider long-term cognitive screening and management for individuals with a history of TBI, particularly those with moderate-to-severe injuries.https://www.mdpi.com/2076-3425/14/12/1188traumatic brain injurymildmoderate to severedementiaAlzheimer’s diseaserisk |
| spellingShingle | Ioannis Mavroudis Dimitrios Kazis Foivos Efstratios Petridis Ioana-Miruna Balmus Vasileios Papaliagkas Alin Ciobica The Association Between Traumatic Brain Injury and the Risk of Cognitive Decline: An Umbrella Systematic Review and Meta-Analysis Brain Sciences traumatic brain injury mild moderate to severe dementia Alzheimer’s disease risk |
| title | The Association Between Traumatic Brain Injury and the Risk of Cognitive Decline: An Umbrella Systematic Review and Meta-Analysis |
| title_full | The Association Between Traumatic Brain Injury and the Risk of Cognitive Decline: An Umbrella Systematic Review and Meta-Analysis |
| title_fullStr | The Association Between Traumatic Brain Injury and the Risk of Cognitive Decline: An Umbrella Systematic Review and Meta-Analysis |
| title_full_unstemmed | The Association Between Traumatic Brain Injury and the Risk of Cognitive Decline: An Umbrella Systematic Review and Meta-Analysis |
| title_short | The Association Between Traumatic Brain Injury and the Risk of Cognitive Decline: An Umbrella Systematic Review and Meta-Analysis |
| title_sort | association between traumatic brain injury and the risk of cognitive decline an umbrella systematic review and meta analysis |
| topic | traumatic brain injury mild moderate to severe dementia Alzheimer’s disease risk |
| url | https://www.mdpi.com/2076-3425/14/12/1188 |
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