SYSTEMATIC REVIEW article
Front. Neurol.
Sec. Dementia and Neurodegenerative Diseases
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1600952
Constipation and Risk of Cognitive Impairment and Dementia in Adults: A Systematic Review and Meta-analysis
Provisionally accepted
- Department of Gastroenterology,Beijing Tsinghua Changgung Hospital,School of Clinical Medicine,Tsinghua Medicine,Tsinghua University, Beijing, China
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Introduction: It has been shown that constipation may have a close association with the occurrence of cognitive impairment(CI). This study was aimed at assessing the risk of CI in patients with constipation and exploring the interactions of constipation with other factors affecting CI.Methods: Embase, PubMed, Web of Science, and Cochrane were systematically searched to collect relevant literature for assessment of the association between constipation and CI. The included studies was subjected to quality assessment using the NIH quality assessment tool for observational cohort and cross-sectional studies. An odds ratio(OR) was calculated using a random effects model, and subgroup and sensitivity analyses were performed. Publication bias was assessed by the Egger's test and funnel plot, with a P-value of < 0.05 considered to indicate the presence of bias.Results: A total of 11 studies were included, including five retrospective studiesand six cross-sectional studies, with 66,609 participants involved. The OR between constipation and cognitive impairment was 1.11(95% CI: 1.03-1.20). Subgroup analysis showed that the OR between constipation and CI was 1.33(95% CI: 1.12-1.58) in patients with Parkinson's disease and 1.05(95% CI: 0.98-1.13) in patients without Parkinson's disease. The OR was 1.37(95% CI: 1.07-1.74) in retrospective studies and 1.06 (95% CI: 0.98-1.15) in cross-sectional studies. The OR was 1.29 (95% CI: 0.92-1.80) in Europe and 1.12 (95% CI: 1.04-1.22) in Asia.Conclusion: The risk of CI was 1.11 times higher in constipated patients than in non-constipated patients. Constipation might significantly increase the risk of CI, especially in patients with Parkinson's disease.
Keywords: Constipation, Colonic inertia, cognitive dysfunction, Dementia, Alzheimer Disease, cognitive disability
Received: 27 Mar 2025; Accepted: 14 May 2025.
Copyright: © 2025 Wang, Yi and Jiang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xuan Jiang, Department of Gastroenterology,Beijing Tsinghua Changgung Hospital,School of Clinical Medicine,Tsinghua Medicine,Tsinghua University, Beijing, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.