Research Reports - The association of traumatic brain injury with rate of progression of cognitive and functional impairment in Alzheimer's disease

Int Psychogeriatr. 2014 May 15:1-9

Gilbert M(1), Snyder C(1), Corcoran C(2), Norton MC(1), Lyketsos CG(3), Tschanz JT(1)

ABSTRACT Background: There is limited research on factors that influence the rate
of progression in Alzheimer's disease (AD). A history of traumatic brain injury
(TBI) is associated with an increased risk for AD, but its role on the rate of
dementia progression after the onset of AD has not been examined. Methods: A
population-based cohort of 325 persons with incident AD was followed for up to 11
years. The sample was 65% female with a mean (SD) age of dementia onset = 84.4
(6.4) years. History of TBI was categorized as number, severity (with or without
loss of consciousness), and timing in relation to dementia onset (within ten
years or more than ten years). Cognition was assessed by the Consortium to
Establish a Registry of AD battery, and functional ability was assessed by the
Clinical Dementia Rating Sum of Boxes. Results: In linear mixed models, a history
of TBI within ten years of onset showed faster progression of functional
impairment (LR x2 = 10.27, p = 0.006), while those with TBI more than ten years
before dementia onset had higher scores on a measure of list learning (β = 1.61,
p = 0.003) and semantic memory (β = 0.75, p = 0.0035). Conclusions: History of
TBI and its recency may be a useful factor to predict functional progression in
the course of AD.

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