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创伤性脑损伤与痴呆和阿尔茨海默病风险:系统评价和荟萃分析。

Traumatic Brain Injury and Risk of Dementia and Alzheimer's Disease: A Systematic Review and Meta-Analysis.

机构信息

Department of Epidemiology and Biostatistics, First Affiliated Hospital, Army Medical University, Chongqing, China,

Department of Anesthesiology, First People's Hospital of Chengdu, Chengdu, China.

出版信息

Neuroepidemiology. 2022;56(1):4-16. doi: 10.1159/000520966. Epub 2021 Nov 24.

Abstract

INTRODUCTION

Previous studies have investigated the potential role of traumatic brain injury (TBI) in subsequent development of dementia and Alzheimer's disease (AD) but reported inconsistent results. We aimed to determine the association between TBI and subsequent occurrence of dementia and AD.

METHODS

We performed a systematic search in PubMed and Web of Science for studies that quantitatively investigated the association between TBI and risk of dementia and AD and were published on or before September 21, 2021. A random-effects model was used to combine the estimates.

RESULTS

Twenty-five eligible articles were included in this meta-analysis. The results suggested that TBI was associated with an increased risk of dementia (pooled odds ratio [OR] = 1.81, 95% confidence interval [CI] = 1.53-2.14). However, no association was observed between TBI and AD (pooled OR = 1.02, 95% CI = 0.91-1.15). In the subgroup analysis, TBI with loss of consciousness was not associated with risk of dementia (pooled OR = 0.96, 95% CI = 0.84-1.09). Besides, Asian ethnicity, male gender, and mean age of the participants less than 65 years were associated with a higher risk of dementia.

CONCLUSION

Our study suggests an increased risk of dementia among individuals with TBI, highlighting the need for more intensive medical monitoring and health education in individuals with TBI. Biological mechanisms linking TBI and the development of dementia are needed in future studies.

摘要

简介

先前的研究已经探讨了创伤性脑损伤(TBI)在随后发生痴呆和阿尔茨海默病(AD)中的潜在作用,但报告的结果不一致。我们旨在确定 TBI 与随后发生痴呆和 AD 的关联。

方法

我们在 PubMed 和 Web of Science 中进行了系统检索,以确定定量研究 TBI 与痴呆和 AD 风险之间关联的研究,并在 2021 年 9 月 21 日或之前发表。使用随机效应模型合并估计值。

结果

共有 25 篇符合条件的文章纳入了这项荟萃分析。结果表明,TBI 与痴呆风险增加相关(汇总优势比 [OR] = 1.81,95%置信区间 [CI] = 1.53-2.14)。然而,TBI 与 AD 之间没有关联(汇总 OR = 1.02,95% CI = 0.91-1.15)。在亚组分析中,伴有意识丧失的 TBI 与痴呆风险无关(汇总 OR = 0.96,95% CI = 0.84-1.09)。此外,亚洲种族、男性性别和参与者平均年龄小于 65 岁与痴呆风险增加相关。

结论

我们的研究表明,TBI 患者痴呆风险增加,这强调了需要对 TBI 患者进行更强化的医疗监测和健康教育。未来的研究需要探讨 TBI 与痴呆发展之间的生物学机制。

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