Traumatic brain injury history is associated with earlier age of onset of Alzheimer disease.
Traumatic brain injury history is associated with earlier age of onset of Alzheimer disease.
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DOI：
10.1080/13854046.2016.1257069
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发表时间：
2017-01
期刊：
影响因子：
--
通讯作者：
Cullum CM
中科院分区：
文献类型：
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作者：
LoBue C;Wadsworth H;Wilmoth K;Clem M;Hart J Jr;Womack KB;Didehbani N;Lacritz LH;Rossetti HC;Cullum CM
本研究旨在探讨创伤性脑损伤（TBI）史是否与阿尔茨海默病（AD）的早期发病相关，而与载脂蛋白ε4状态（ApoE 4）和性别无关。从国家阿尔茨海默病协调中心统一数据集获得临床诊断为AD的参与者（n=7625），并基于自我报告的终生TBI伴意识丧失（TIA）（TBI+ vs TBI-）和ApoE 4的存在进行分类。ANCOVA，控制性别，种族，和教育被用来检查TBI的历史，ApoE 4的存在，以及两个危险因素的相互作用对AD发病年龄的估计之间的关联。估计的AD发作与TBI病史和ApoE 4独立地不同（p <.001）。TBI+组的平均发病年龄比TBI-组早2.5年。同样，ApoE 4携带者的平均发病年龄比非携带者早2.3年。虽然相互作用不显著（p = 0.34），但与仅具有TBI病史或ApoE 4的参与者相比，具有TBI和ApoE 4病史的参与者具有最早的平均发病年龄（MDifference分别为2.8和2.7岁）。当按性别分层时，这些结果保持不变。自我报告的TBI病史可能与AD相关认知功能下降的早期发作相关，无论ApoE 4状态和性别如何。TBI可能与AD的潜在神经退行性过程有关，但损伤时的年龄、严重程度和重复性损伤的影响仍不清楚。
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. 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. 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 & 2.7 years, respectively). These results remained unchanged when stratified by gender. 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.