Association Between Cortical Superficial Siderosis and Dementia in Patients With Cognitive Impairment: A Meta-Analysis

Background: It remains unclear whether cortical superficial siderosis (cSS) is associated with dementia and its subtypes. We thus performed a meta-analysis to evaluate the relationship between dementia and cSS. Methods: We searched EMBASE, PubMed, and Web of Science for relevant studies assessing risk of dementia and prevalence of cSS in patients with cognitive impairment. Fixed-effects and random-effects models were performed. Results: Seven eligible studies including 3,218 patients with definite cognitive impairment were pooled in meta-analysis. The prevalence of cSS was 3.4%. The pooled analysis demonstrates odds ratio for cSS and dementia to be 1.60 (95% CI 1.04–2.44; p = 0.031). Subgroup analysis further indicated a significant association between cSS and Alzheimer's disease (AD) (OR = 2.01, 95% CI 1.34–3.02; p < 0.001), but not non-AD dementia (OR = 0.700, 95% CI 0.435–1.128; p = 0.143). Conclusions: Our meta-analysis of available published data demonstrates an increased prevalence of dementia in the subjects with pre-existing cSS, especially for AD. These findings suggest cSS to be a candidate imaging indicator for AD. Further longitudinal research is needed to investigate the clinical relevance.