Traumatic brain injury history is associated with earlier age of onset of Alzheimer disease

LoBue, Christian; Wadsworth, Hannah E.; Wilmoth, Kristin; Clem, M; Hart, John; Womack, Kyle; Didehbani, Nyaz; Lacritz, Laura H.; Rossetti, Heidi; Cullum, C. Munro

doi:10.1080/13854046.2016.1257069

Cited by 75 publications

(61 citation statements)

References 54 publications

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“…These results confirm prior studies, including a 2008 Institute of Medicine report, 8 that have found an association between moderate to severe TBI and risk of dementia. 1,8,11,13,21,40 In addition, although prior studies of the association between mild TBI and dementia have been mixed, [2][3][4][5][6] our study adds to the weight of evidence suggesting that mild TBI is also associated with increased dementia diagnosis risk. [14][15][16]37,41 Our results differ from several recent cohort studies that found no association between self-reported mild TBI and dementia risk.…”

Section: Discussionmentioning

confidence: 81%

Association of Mild Traumatic Brain Injury With and Without Loss of Consciousness With Dementia in US Military Veterans

et al. 2018

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IMPORTANCE Traumatic brain injury (TBI) is common in both veteran and civilian populations. Prior studies have linked moderate and severe TBI with increased dementia risk, but the association between dementia and mild TBI, particularly mild TBI without loss of consciousness (LOC), remains unclear. OBJECTIVE To examine the association between TBI severity, LOC, and dementia diagnosis in veterans. DESIGN, SETTING, AND PARTICIPANTS This cohort study of all patients diagnosed with a TBI in the Veterans Health Administration health care system from October 1, 2001, to September 30, 2014, and a propensity-matched comparison group. Patients with dementia at baseline were excluded. Researchers identified TBIs through the Comprehensive TBI Evaluation database, which is restricted to Iraq and Afghanistan veterans, and the National Patient Care Database, which includes veterans of all eras. The severity of each TBI was based on the most severe injury recorded and classified as mild without LOC, mild with LOC, mild with LOC status unknown, or moderate or severe using Department of Defense or Defense and Veterans Brain Injury Center criteria. International Classification of Diseases, Ninth Revision codes were used to identify dementia diagnoses during follow-up and medical and psychiatric comorbidities in the 2 years prior to the index date. MAIN OUTCOMES AND MEASURES Dementia diagnosis in veterans who had experienced TBI with or without LOC and control participants without TBI exposure. RESULTS The study included 178 779 patients diagnosed with a TBI in the Veterans Health Administration health care system and 178 779 patients in a propensity-matched comparison group. Veterans had a mean (SD) age of nearly 49.5 (18.2) years at baseline; 33 250 (9.3%) were women, and 259 136 (72.5%) were non-Hispanic white individuals. Differences between veterans with and without TBI were small. A total of 4698 veterans (2.6%) without TBI developed dementia compared with 10 835 (6.1%) of those with TBI. After adjustment for demographics and medical and psychiatric comobidities, adjusted hazard ratios for dementia were 2.36 (95% CI, 2.10-2.66) for mild TBI without LOC, 2.51 (95% CI, 2.29-2.76) for mild TBI with LOC, 3.19 (95% CI, 3.05-3.33) for mild TBI with LOC status unknown, and 3.77 (95% CI, 3.63-3.91) for moderate to severe TBI. CONCLUSIONS AND RELEVANCE In this cohort study of more than 350 000 veterans, even mild TBI without LOC was associated with more than a 2-fold increase in the risk of dementia diagnosis. Studies of strategies to determine mechanisms, prevention, and treatment of TBI-related dementia in veterans are urgently needed.

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Section: Discussionmentioning

confidence: 81%

Association of Mild Traumatic Brain Injury With and Without Loss of Consciousness With Dementia in US Military Veterans

et al. 2018

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“…A recent study found that mild TBI is associated with a two‐fold increase in the risk of dementia diagnosis 173 . Another study found that people with a history of TBI who develop Alzheimer's do so at a younger age than those without a history of TBI 174 . Whether TBI causes Alzheimer's disease, other conditions that lead to dementia, or both, is still being investigated.…”

Section: Overview Of Alzheimer's Diseasementioning

confidence: 99%

2020 Alzheimer's disease facts and figures

2020

Alzheimer's & Dementia

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653

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This article describes the public health impact of Alzheimer's disease (AD), including incidence and prevalence, mortality and morbidity, use and costs of care, and the overall impact on caregivers and society. The Special Report discusses the future challenges of meeting care demands for the growing number of people living with Alzheimer's dementia in the United States with a particular emphasis on primary care. By mid‐century, the number of Americans age 65 and older with Alzheimer's dementia may grow to 13.8 million. This represents a steep increase from the estimated 5.8 million Americans age 65 and older who have Alzheimer's dementia today. Official death certificates recorded 122,019 deaths from AD in 2018, the latest year for which data are available, making Alzheimer's the sixth leading cause of death in the United States and the fifth leading cause of death among Americans age 65 and older. Between 2000 and 2018, deaths resulting from stroke, HIV and heart disease decreased, whereas reported deaths from Alzheimer's increased 146.2%. In 2019, more than 16 million family members and other unpaid caregivers provided an estimated 18.6 billion hours of care to people with Alzheimer's or other dementias. This care is valued at nearly $244 billion, but its costs extend to family caregivers’ increased risk for emotional distress and negative mental and physical health outcomes. Average per‐person Medicare payments for services to beneficiaries age 65 and older with AD or other dementias are more than three times as great as payments for beneficiaries without these conditions, and Medicaid payments are more than 23 times as great. Total payments in 2020 for health care, long‐term care and hospice services for people age 65 and older with dementia are estimated to be $305 billion. As the population of Americans living with Alzheimer's dementia increases, the burden of caring for that population also increases. These challenges are exacerbated by a shortage of dementia care specialists, which places an increasing burden on primary care physicians (PCPs) to provide care for people living with dementia. Many PCPs feel underprepared and inadequately trained to handle dementia care responsibilities effectively. This report includes recommendations for maximizing quality care in the face of the shortage of specialists and training challenges in primary care.

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“…Es gibt Hinweise, dass schwere SHT das Auftreten eines M.Alzheimer beschleunigen können (LoBue et al 2017). Eine Übersicht stellt die Assoziation mit M.Alzheimer in Frage, sondern sieht eher eine Assoziation mit anderen neurodegenerativen Erkrankungen (Weiner et al 2017).…”

Section: Vorgezogene Dementielle Entwicklungunclassified

Leitlinie „Begutachtung nach gedecktem Schädel-Hirntrauma im Erwachsenenalter“

Cw¹,

Marx²,

Tegenthoff³

et al. 2018

Fortschr Neurol Psychiatr

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Zusammenfassung2005 und 2013 hat die Deutsche Gesellschaft für Neurowissenschaftliche Begutachtung gemeinsam mit anderen Fachgesellschaften und Verbänden „Leitlinien zur Begutachtung nach gedecktem Schädel-Hirntrauma“ erarbeitet und über die Arbeitsgemeinschaft wissenschaftlicher medizinischer Fachgesellschaften (AWMF) sowie in den Fortschritten der Neurologie und Psychiatrie publiziert. Nach 5 Jahren war eine Revision der Leitlinie erforderlich, diese erfolgte erstmals auf der höheren Entwicklungsstufe S 2 k (Expertenkonsens via Delphi-Konferenz).

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Traumatic brain injury history is associated with earlier age of onset of Alzheimer disease

Cited by 75 publications

References 54 publications

Association of Mild Traumatic Brain Injury With and Without Loss of Consciousness With Dementia in US Military Veterans

Association of Mild Traumatic Brain Injury With and Without Loss of Consciousness With Dementia in US Military Veterans

2020 Alzheimer's disease facts and figures

Leitlinie „Begutachtung nach gedecktem Schädel-Hirntrauma im Erwachsenenalter“

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