TY - JOUR
T1 - Traumatic brain injury history is associated with earlier age of onset of Alzheimer disease
AU - LoBue, Christian
AU - Wadsworth, Hannah
AU - Wilmoth, Kristin
AU - Clem, Matthew
AU - Hart, John
AU - Womack, Kyle B.
AU - Didehbani, Nyaz
AU - Lacritz, Laura H.
AU - Rossetti, Heidi C.
AU - Cullum, C. Munro
N1 - Funding Information:
This work was supported by the University of Texas Southwestern Alzheimer's Disease Center [NIH/NIA grant number P3012300-19] and the Texas Alzheimer's Research and Care Consortium (TARCC). NACC data are funded by NIA [grant number P30 AG019610] (PI Eric Reiman, MD), [grant number P30 AG013846] (PI Neil Kowall, MD), [grant number P50 AG008702] (PI Scott Small, MD), [grant number P50 AG025688] (PI Allan Levey, MD, PhD), [grant number P30 AG010133] (PI Andrew Saykin, PsyD), [grant number P50 AG005146] (PI Marilyn Albert, PhD), [grant number P50 AG005134] (PI Bradley Hyman, MD, PhD), [grant number P50 AG016574] (PI Ronald Petersen, MD, PhD), [grant number P50 AG005138] (PI Mary Sano, PhD), [grant number P30 AG008051] (PI Steven Ferris, PhD), [grant number P30 AG013854] (PI M. Marsel Mesulam, MD), [grant number P30 AG008017] (PI Jeffrey Kaye, MD), [grant number P30 AG010161] (PI David Bennett, MD), [grant number P30 AG010129] (PI Charles DeCarli, MD), [grant number P50 AG016573] (PI Frank LaFerla, PhD), [grant number P50 AG016570] (PI David Teplow, PhD), [grant number P50 AG005131] (PI Douglas Galasko, MD), [grant number P50 AG023501] (PI Bruce Miller, MD), [grant number P30 AG035982] (PI Russell Swerdlow, MD), [grant number P30 AG028383] (PI Linda Van Eldik, PhD), [grant number P30 AG010124] (PI John Trojanowski, MD, PhD), [grant number P50 AG005133] (PI Oscar Lopez, MD), [grant number P50 AG005142] (PI Helena Chui, MD), [grant number P30 AG012300] (PI Roger Rosenberg, MD), [grant number P50 AG005136] (PI Thomas Montine, MD, PhD), [grant number P50 AG033514] (PI Sanjay Asthana, MD, FRCP), [grant number P50 AG005681] (PI John Morris, MD); Alzheimer’s Disease Genetic Consortium (ADGC) is funded by NIA [grant number U01 AG032984].
Publisher Copyright:
© 2016 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2017/1/2
Y1 - 2017/1/2
N2 - Objective: This study examined whether a history of traumatic brain injury (TBI) is associated with earlier onset of Alzheimer disease (AD), independent of apolipoprotein ε4 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 2.5 years earlier than the TBI− group. Likewise, Apoe4 carriers had a mean age of onset 2.3 years 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 (MDifference = 2.8 and 2.7 years, 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.
AB - Objective: This study examined whether a history of traumatic brain injury (TBI) is associated with earlier onset of Alzheimer disease (AD), independent of apolipoprotein ε4 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 2.5 years earlier than the TBI− group. Likewise, Apoe4 carriers had a mean age of onset 2.3 years 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 (MDifference = 2.8 and 2.7 years, 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.
KW - Alzheimer’s disease (AD)
KW - National Alzheimer’s Coordinating Center (NACC)
KW - age of onset
KW - dementia
KW - traumatic brain injury (TBI)
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U2 - 10.1080/13854046.2016.1257069
DO - 10.1080/13854046.2016.1257069
M3 - Article
C2 - 27855547
AN - SCOPUS:84995674788
SN - 1385-4046
VL - 31
SP - 85
EP - 98
JO - Clinical Neuropsychologist
JF - Clinical Neuropsychologist
IS - 1
ER -