TY - JOUR
T1 - History of Traumatic Brain Injury Does Not Alter Course of Neurocognitive Decline in Older Adults With and Without Cognitive Impairment
AU - Schaffert, Jeff
AU - Chiang, Hsueh Sheng
AU - Fatima, Hudaisa
AU - LoBue, Christian
AU - Hart, John
AU - Cullum, C. Munro
N1 - Publisher Copyright:
© 2023 American Psychological Association
PY - 2023/4/6
Y1 - 2023/4/6
N2 - Objective: Traumatic brain injury (TBI) history is associated with dementia risk, but it is unclear whether TBI history significantly hastens neurocognitive decline in older adults. Method: Data were derived from the National Alzheimer’s Coordinating Center (NACC) data set. Participants with a history of TBI (TBI+; n = 1, 467) were matched to individuals without a history of TBI (TBI−; n = 1, 467) based on age (50–97, M = 71.61, SD = 8.40), sex, education, race, ethnicity, cognitive diagnosis, functional decline, number of Apolipoprotein ε4 (APOE ε4) alleles, and number of annual visits (3–6). Mixed linear models were used to assess longitudinal neuropsychological test composite scores of executive functioning/attention/speed, language, and memory in TBI+ and TBI− participants. Interactions between TBI and demographics, APOE ε4 status, and cognitive diagnosis were also examined. Results: Longitudinal neuropsychological functioning did not differ between TBI groups (p’s >.001). There was a significant three-way interaction (age, TBI history, time) in language (F[20, 5750.1] = 3.133, p <.001) and memory performance (F[20, 6580.8] = 3.386, p <.001), but post hoc analyses revealed TBI history was not driving this relationship (all p’s >.096). No significant interactions were observed between TBI history and sex, education, race/ethnicity, number of APOE ε4 alleles, or cognitive diagnosis (p’s >.001). Conclusions: Findings suggest TBI history, regardless of demographic factors, APOE ε4 status, or cognitive diagnosis, does not alter the course of neurocognitive functioning later-in-life in older adults with or without cognitive impairment. Future clinicopathological longitudinal studies that well-characterize head injuries and the associated clinical course are needed to help clarify the mechanism in which TBI may increase dementia risk.
AB - Objective: Traumatic brain injury (TBI) history is associated with dementia risk, but it is unclear whether TBI history significantly hastens neurocognitive decline in older adults. Method: Data were derived from the National Alzheimer’s Coordinating Center (NACC) data set. Participants with a history of TBI (TBI+; n = 1, 467) were matched to individuals without a history of TBI (TBI−; n = 1, 467) based on age (50–97, M = 71.61, SD = 8.40), sex, education, race, ethnicity, cognitive diagnosis, functional decline, number of Apolipoprotein ε4 (APOE ε4) alleles, and number of annual visits (3–6). Mixed linear models were used to assess longitudinal neuropsychological test composite scores of executive functioning/attention/speed, language, and memory in TBI+ and TBI− participants. Interactions between TBI and demographics, APOE ε4 status, and cognitive diagnosis were also examined. Results: Longitudinal neuropsychological functioning did not differ between TBI groups (p’s >.001). There was a significant three-way interaction (age, TBI history, time) in language (F[20, 5750.1] = 3.133, p <.001) and memory performance (F[20, 6580.8] = 3.386, p <.001), but post hoc analyses revealed TBI history was not driving this relationship (all p’s >.096). No significant interactions were observed between TBI history and sex, education, race/ethnicity, number of APOE ε4 alleles, or cognitive diagnosis (p’s >.001). Conclusions: Findings suggest TBI history, regardless of demographic factors, APOE ε4 status, or cognitive diagnosis, does not alter the course of neurocognitive functioning later-in-life in older adults with or without cognitive impairment. Future clinicopathological longitudinal studies that well-characterize head injuries and the associated clinical course are needed to help clarify the mechanism in which TBI may increase dementia risk.
KW - cognitive decline
KW - dementia
KW - mild cognitive impairment
KW - normal aging
KW - traumatic brain injury
UR - http://www.scopus.com/inward/record.url?scp=85158101315&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85158101315&partnerID=8YFLogxK
U2 - 10.1037/neu0000892
DO - 10.1037/neu0000892
M3 - Article
C2 - 37023289
AN - SCOPUS:85158101315
SN - 0894-4105
VL - 37
SP - 923
EP - 932
JO - Neuropsychology
JF - Neuropsychology
IS - 8
ER -