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Does inflammatory bowel disease play a role in cognitive decline? A systematic review
Motisi Bertulli A, Bezzio C, Marsano S, Corradini I, Stranges S, Matteoli M, Armuzzi A.. Journal of Crohn's & colitis, 2026-05-01
Topic: Risk, prevention and care in population studies
Background & aims Inflammatory bowel disease (IBD) has been increasingly linked to cognitive impairment (CI) and dementia, yet the underlying mechanisms driving this association remain poorly understood and population, clinical and experimental studies show controversial results. Among others, factors such as chronic inflammation, gut-brain axis dysfunction, and psychological comorbidities have been proposed as contributors to cognitive deficits in IBD patients. The objective of this systematic review was to evaluate the existing literature on the relationship between IBD and cognitive function, considering observational and preclinical studies, with the aim to identify key factors influencing CI and potential clinical implications. The main focus of this review is on the use of IBD treatments, which may have a potential impact on CI. Methods We conducted a systematic review according to PRISMA guidelines. PubMed and Scopus were searched from database inception up to August 30, 2024, for studies assessing cognitive performance in individuals with IBD. Clinical and epidemiological studies, genetic investigations (Mendelian Randomization and Genome-wide Association studies), and preclinical models examining memory, attention, and executive functions were included. Two reviewers independently extracted data and assessed methodological quality and risk of bias. Results The research yielded 66 included studies, including 31 populations studies, 13 genetics studies, and 22 preclinical research studies. Our findings suggest that patients with IBD may exhibit impaired cognitive function, particularly in memory, attention, and executive processing. Disease activity, chronic inflammation and psychological stress appear to contribute to these deficits, while some treatment strategies seem to mitigate the risk of CI. Conclusion IBD is associated with CI and increased dementia risk, with biologics potentially mitigating neuroinflammation-related decline. More longitudinal studies and randomized clinical trials, also on intermediate endpoints, are needed to clarify the neuroprotective role of some therapies and optimize treatment strategies.
Key findings
- Background & aims Inflammatory bowel disease (IBD) has been increasingly linked to cognitive impairment (CI) and dementia, yet the underlying mechanisms driving this association remain poorly understood and population, clinical and experimental studies show controversial results.
- Results The research yielded 66 included studies, including 31 populations studies, 13 genetics studies, and 22 preclinical research studies.
- Our findings suggest that patients with IBD may exhibit impaired cognitive function, particularly in memory, attention, and executive processing.
- Conclusion IBD is associated with CI and increased dementia risk, with biologics potentially mitigating neuroinflammation-related decline.
Why it matters
Reviewing 66 studies, including population, genetic and animal research, the authors found that people with inflammatory bowel disease may have weaker memory, attention and executive function. They conclude the condition is associated with cognitive impairment and higher dementia risk, and that biologic treatments may help limit inflammation-related decline. They call for more long-term studies and randomized trials to confirm whether any therapies are protective.
Study details
- Study designsystematic review
- Evidence strengthHigh
How this study scored 49/100
Published in a peer-reviewed journal, and it is a systematic review of all the studies on the question. Scored zero for sample size, effect reported and studied in people because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of Crohn's & colitis) |
| Journal's citation record | 2 / 4 | Journal of Crohn s and Colitis: journal h-index 152 (OpenAlex, 2026-10-29) |
| Study design | 12 / 12 | A systematic review of all the studies on the question |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | A review of other studies — randomisation is not credited here |
| Times cited | 0 / 7 | Cited 0 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.0 citations a year over 2 year(s) since 2026 |
| Impact for its field and year | 0 / 6 | Cited 0.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 0 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Alessandro Armuzzi: h-index 73 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Western University: institution h-index 899 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 5 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 42172661) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 49 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
APA 7th
Motisi Bertulli, A., Bezzio, C., Marsano, S., Corradini, I., Stranges, S., Matteoli, M., et al. (2026). Does inflammatory bowel disease play a role in cognitive decline? A systematic review. Journal of Crohn's & colitis. https://doi.org/10.1093/ecco-jcc/jjag057
Vancouver
Motisi Bertulli A, Bezzio C, Marsano S, Corradini I, Stranges S, Matteoli M, et al. Does inflammatory bowel disease play a role in cognitive decline? A systematic review. Journal of Crohn's & colitis. 2026. doi:10.1093/ecco-jcc/jjag057. PMID: 42172661.
BibTeX
@article{motisibertulli2026-42172661,
author = {Motisi Bertulli, A. and Bezzio, C. and Marsano, S. and Corradini, I. and Stranges, S. and Matteoli, M. and Armuzzi, A.},
title = {{Does inflammatory bowel disease play a role in cognitive decline? A systematic review}},
journal = {Journal of Crohn's \& colitis},
year = {2026},
doi = {10.1093/ecco-jcc/jjag057},
pmid = {42172661},
url = {https://doi.org/10.1093/ecco-jcc/jjag057}
}
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