Chronic rhinosinusitis and cognition: a systematic review and meta-analysis

Background: Recent clinical studies have alluded to an association between chronic rhinosinusitis (CRS) and cognition, possibly mediated by local and systemic neuroinflammation. This meta-analysis seeks to clarify the association of CRS diagnosis or treatment with cognitive function and dementia. Methodology: Two blinded reviewers searched PubMed, Embase, and Scopus for studies comparing cognitive function (global/domain-specific) or dementia in patients with/without CRS or pre/post-CRS treatment. The risk of bias was assessed using ROBINS-I/ROBINS-E. Random-effects models were used to pool the ratio of means (RoM) for cognitive scores and the odds ratio (OR) for dementia. Results: From 1,149 records, 10 studies encompassing 107,610 patients were included. CRS was associated with poorer global cognitive function compared to healthy. CRS treatment was associated with improvements from baseline in processing speed and working memory. There was no significant cross-sectional association between CRS and dementia. Conclusion: CRS is associated with 9% poorer global cognitive function, while CRS treatment is associated with 8-9% improvements in processing speed and working memory. Larger longitudinal studies are needed to fully elucidate these relationships.