Graham, Alicia;
Livingston, Gill;
Purnell, Lucy;
Huntley, Jonathan;
(2022)
Mild Traumatic Brain Injuries and Future Risk of Developing Alzheimer's Disease: Systematic Review and Meta-Analysis.
Journal of Alzheimer's Disease
, 87
(3)
pp. 969-979.
10.3233/JAD-220069.
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Abstract
BACKGROUND: Traumatic brain injury (TBI) increases the risk of future dementia and Alzheimer's disease (AD). However, it is unclear whether this is true for mild TBI (mTBI). OBJECTIVE: To explore the association between mTBI and subsequent risk of developing AD. METHOD: We systematically searched four electronic databases from January 1954 to April 2020. We included studies reporting primary data and where mTBI preceded AD by≥5 years. We meta-analyzed included studies for both high quality studies and studies with a follow up of > 10 years. RESULT: We included 5 of the 10,435 results found. Meta-analysis found a history of mTBI increased risk of AD (pooled relative risk = 1.18, 95% CI 1.11-1.25, N = 3,149,740). The sensitivity analysis including only studies in which mTBI preceded AD by > 10 years, excluded two very large studies and resulted in wider confidence intervals (RR = 2.02, 95% CI 0.66-6.21, N = 2307). CONCLUSION: There is an increased risk of AD following mTBI. Our findings of increased risk even with mTBI means it cannot be assumed that mild head injuries from sports are harmless. The sensitivity analysis suggests that we cannot exclude reverse causation, and longer follow up times are needed. Implementation of policy to reduce mTBIs, including in children and sportsmen, are urgently needed. Further research is needed on the effect of frequency and age at injury of mTBIs.
| Type: | Article |
|---|---|
| Title: | Mild Traumatic Brain Injuries and Future Risk of Developing Alzheimer's Disease: Systematic Review and Meta-Analysis |
| Location: | Netherlands |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.3233/JAD-220069 |
| Publisher version: | http://doi.org/10.3233/JAD-220069 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. // This review did not receive any specific funding. JH is funded by a Wellcome Clinical Research Career Development Fellowship. This research was funded in whole, or in part, by the Wellcome Trust [Grant number 214547/Z/18/Z ]. For the purpose of open access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission. GL is supported by University College London Hospitals’ National Institute for Health Research (NIHR) Biomedical Research Centre, North Thames NIHR Applied Research Collaboration, as an NIHR Senior Investigator. |
| Keywords: | Alzheimer’s disease, meta-analysis, risk factor, systematic review, traumatic brain injury |
| UCL classification: | UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10151269 |
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