Research Reports - Clinical phenotype of dementia after traumatic brain injury

J Neurotrauma. 2013 Jul 1;30(13):1117-22

Sayed N, Culver C, Dams-O'Connor K, Hammond F, Diaz-Arrastia R

Abstract Traumatic brain injury (TBI) in early to mid-life is associated with an
increased risk of dementia in late life. It is unclear whether TBI results in
acceleration of Alzheimer's disease (AD)-like pathology or has features of
another dementing condition, such as chronic traumatic encephalopathy, which is
associated with more-prominent mood, behavior, and motor disturbances than AD.
Data from the National Alzheimer's Coordinating Center (NACC) Uniform Data Set
was obtained over a 5-year period. Categorical data were analyzed using Fisher's
exact test. Continuous parametric data were analyzed using the Student's t-test.
Nonparametric data were analyzed using Mann-Whitney's test. Overall, 877
individuals with dementia who had sustained TBI were identified in the NACC
database. Only TBI with chronic deficit or dysfunction was associated with
increased risk of dementia. Patients with dementia after TBI (n=62) were
significantly more likely to experience depression, anxiety, irritability, and
motor disorders than patients with probable AD. Autopsy data were available for
20 of the 62 TBI patients. Of the patients with TBI, 62% met National Institute
of Aging-Reagan Institute "high likelihood" criteria for AD. We conclude that TBI
with chronic deficit or dysfunction is associated with an increased odds ratio
for dementia. Clinically, patients with dementia associated with TBI were more
likely to have symptoms of depression, agitation, irritability, and motor
dysfunction than patients with probable AD. These findings suggest that dementia
in individuals with a history of TBI may be distinct from AD.

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