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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Main Authors: Ioannis Mavroudis, Dimitrios Kazis, Foivos Efstratios Petridis, Ioana-Miruna Balmus, Vasileios Papaliagkas, Alin Ciobica
Format: Article
Language:English
Published: MDPI AG 2024-11-01
Series:Brain Sciences
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Online Access:https://www.mdpi.com/2076-3425/14/12/1188
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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.
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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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