Journal
CLINICAL NEUROPSYCHOLOGIST
Volume 31, Issue 1, Pages 85-98Publisher
TAYLOR & FRANCIS INC
DOI: 10.1080/13854046.2016.1257069
Keywords
National Alzheimer's Coordinating Center (NACC); traumatic brain injury (TBI); dementia; Alzheimer's disease (AD); age of onset
Categories
Funding
- University of Texas Southwestern Alzheimer's Disease Center [NIH/NIA] [P3012300-19]
- Texas Alzheimer's Research and Care Consortium (TARCC)
- NIA [P50 AG005146, P50 AG005134, P50 AG016574, P50 AG005138, P30 AG008051, P30 AG013854, P30 AG008017, P30 AG010161, P30 AG010129, P50 AG016573, P50 AG016570, P50 AG005131, P50 AG023501, P30 AG035982, P30 AG028383, P30 AG010124]
- The NIA [P30 AG019610, P30 AG013846, P50 AG008702, P50 AG025688, P30 AG010133, P50 AG005133, P50 AG005142, P30 AG012300, P50 AG005136, P50 AG033514, P50 AG005681, U01 AG032984]
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Objective: This study examined whether a history of traumatic brain injury (TBI) is associated with earlier onset of Alzheimer disease (AD), independent of apolipoprotein epsilon 4 status (Apoe4) and gender. Method: Participants with a clinical diagnosis of AD (n=7625) were obtained from the National Alzheimer's Coordinating Center Uniform Data Set, and categorized based on self-reported lifetime TBI with loss of consciousness (LOC) (TBI+ vs. TBI-) and presence of Apoe4. ANCOVAs, controlling for gender, race, and education were used to examine the association between history of TBI, presence of Apoe4, and an interaction of both risk factors on estimated age of AD onset. Results: Estimated AD onset differed by TBI history and Apoe4 independently (p's<.001). The TBI+ group had a mean age of onset 2.5years earlier than the TBI- group. Likewise, Apoe4 carriers had a mean age of onset 2.3years earlier than non-carriers. While the interaction was non-significant (p=.34), participants having both a history of TBI and Apoe4 had the earliest mean age of onset compared to those with a TBI history or Apoe4 alone (M-Difference=2.8 and 2.7years, respectively). These results remained unchanged when stratified by gender. Conclusions: History of self-reported TBI can be associated with an earlier onset of AD-related cognitive decline, regardless of Apoe4 status and gender. TBI may be related to an underlying neurodegenerative process in AD, but the implications of age at time of injury, severity, and repetitive injuries remain unclear.
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