{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:25:49Z","timestamp":1786123549960,"version":"build-2736575974"},"reference-count":56,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In the general population, abnormal serum magnesium levels are associated with an increased risk of cognitive decline and dementia. However, whether this association extends to patients with traumatic brain injury (TBI), a population with distinct neurobiological vulnerabilities, remains unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using the TriNetX Global Collaborative Network, we identified adults aged \u226550 years with a history of intracranial injury (ICD-10-CM: S06). Patients with repeatedly low serum magnesium levels (&amp;lt; 1.7 mg\/dL, two measurements within 1 year) were compared with those with normal levels (1.70\u20132.20 mg\/dL) using 1:1 propensity score matching. A 1-year landmark period was applied to reduce the reverse causation. The primary outcome was incident dementia over 10 years of follow-up. The secondary outcomes included dementia subtypes, cognitive dysfunction, and all-cause mortality. To explore a potential U-shaped relationship, a parallel analysis was conducted comparing patients with repeatedly high magnesium levels (&amp;gt;2.20 mg\/dL) with the same reference cohort. Sensitivity analyses, subgroup analyses by sex and TBI severity, and multivariable Cox regression were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After matching, 11,716 patients were retained in each cohort. Low magnesium levels were associated with a higher 10-year risk of incident dementia [2.53% vs. 1.78%; hazard ratio (HR) 1.62, 95% confidence interval (CI), 1.36\u20131.94;\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001]. Among the secondary outcomes, associations were observed for vascular dementia (HR 1.97,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.001), other dementia types (HR 1.63,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001), cognitive dysfunction (HR 1.43,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.009), and all-cause mortality (HR 1.29,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001), whereas Alzheimer's disease did not reach significance (HR 1.43,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.075). High magnesium levels were similarly associated with an increased risk of dementia (HR 1.57,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001). The findings were consistent across sensitivity and subgroup analyses and after multivariable adjustment (adjusted HR 1.50,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In adults with prior TBI, both low and high serum magnesium levels were associated with a greater long-term risk of dementia, suggesting a U-shaped relationship. Prospective studies are needed to determine whether monitoring or modifying magnesium status can alter the post-traumatic dementia trajectory.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2026.1870929","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T15:11:12Z","timestamp":1786115472000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["U-shaped pattern in the association between serum magnesium levels and long-term dementia risk after traumatic brain injury: a retrospective cohort study"],"prefix":"10.3389","volume":"13","author":[{"given":"Kuo-Chuan","family":"Hung","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Chi Mei Medical Center","place":["Tainan City, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsiu-Lan","family":"Weng","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, E-Da Hospital, I-Shou University","place":["Kaohsiung City, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Chen","family":"Lai","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Chi Mei Medical Center","place":["Tainan City, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I-Wen","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Chi Mei Hospital, Liouying","place":["Tainan City, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"969","DOI":"10.3233\/JAD-220069","article-title":"Mild traumatic brain injuries and future risk of developing alzheimer's disease: systematic review and meta-analysis","volume":"87","author":"Graham","year":"2022","journal-title":"J Alzheimers 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