Traumatic Brain Injury Characteristics Are Not Related to Neurocognitive Decline in Older Adults: A Nationwide Longitudinal Cohort Study.
Traumatic Brain Injury Characteristics Are Not Related to Neurocognitive Decline in Older Adults: A Nationwide Longitudinal Cohort Study.
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创伤性脑损伤特征与老年人神经认知能力下降无关：一项全国纵向队列研究。
DOI：
10.1093/arclin/acae003
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发表时间：
2024
期刊：
影响因子：
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通讯作者：
Cullum,CMunro
中科院分区：
文献类型：
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作者：
Schaffert,Jeff;LoBue,Christian;Chiang,Hsueh-Sheng;Peters,MatthewE;HartJr,John;Cullum,CMunro
评估创伤性脑损伤（TBI）特征、损伤年龄或损伤的新近性是否预测神经认知下降的过程和/或增加向轻度认知障碍（MCI）或痴呆的转化率。方法数据来自国家阿尔茨海默病协调中心，参与者年龄为50-85岁，从2015年到2022年进行了3-5次访问。有或无TBI病史（TBI+ = 508; TBI-= 2，382）。根据自我报告的TBI病史（即，无意识丧失的单次TBI、有意识丧失的单次TBI、无意识丧失的多次TBI和有意识丧失的多次TBI）、最近TBI的年龄和TBI的新近度。混合线性模型比较了神经心理复合轨迹（执行功能/注意力/速度，语言，记忆力和全局），年龄，性别，教育，载脂蛋白E4状态，种族/民族和基线诊断（正常年龄n = 1，720，MCIn= 749，或痴呆= 417）。Logistic二元回归研究MCI/痴呆转换rates.ResultsThere是一个频率略高的MCI/痴呆症在那些与多个TBI（50%至60%，无脑外伤，相比39%，无TBI）在基线，但纵向轨迹相似。TBI病史、损伤年龄或损伤新近度并不影响神经认知轨迹或向MCI/痴呆的转化率（allp> 0.01）.ConclusionsTBI病史，无论损伤特征、损伤年龄或损伤新近度如何，都不会使神经认知下降或MCI/痴呆转化恶化。需要在更广泛的TBI严重程度的更多样化队列中进行额外的纵向研究，以评估TBI可能增加痴呆风险的特定因素和可能机制。
ObjectiveEvaluate whether traumatic brain injury (TBI) characteristics, age of injury, or recency of injury predicts the course of neurocognitive decline and/or increases conversion rates to mild cognitive impairment (MCI) or dementia.MethodsData were obtained from the National Alzheimer’s Coordinating Center for participants 50–85 years old with 3–5 visits from 2015 to 2022, with or without TBI history (TBI+ = 508; TBI− = 2,382). Groups were stratified by self-reported TBI history (i.e., single TBI without loss of consciousness [LOC], single TBI with LOC, multiple TBI without LOC, and multiple TBI with LOC), age of most recent TBI, and recency of TBI. Mixed linear models compared neuropsychological composite trajectories (executive functioning/attention/speed, language, memory, and global), co-varying for age, gender, education, apolipoprotein E4 status, race/ethnicity, and baseline diagnosis (normal agingn= 1,720, MCIn= 749, or dementian= 417). Logistic binary regression examined MCI/dementia conversion rates.ResultsThere was a slightly higher frequency of MCI/dementia in those with multiple TBIs (50% to 60% with and without LOC, compared to 39% with no TBI) at baseline, but longitudinal trajectories were similar. TBI history, age of injury, or recency of injury did not impact neurocognitive trajectories or conversion rates to MCI/dementia (allp’s > .01).ConclusionsTBI history, regardless of injury characteristics, age of injury, or recency of injury, did not worsen neurocognitive decline or MCI/dementia conversion. Additional longitudinal research in more diverse cohorts with a wider range of TBI severity is needed to evaluate the specific factors and possible mechanisms in which TBI may increase dementia risk.