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. 2018 May;32(4):401-409.
doi: 10.1037/neu0000431.

Traumatic brain injury history and progression from mild cognitive impairment to Alzheimer disease

Christian LoBue  1 , Fu L Woon  2 , Heidi C Rossetti  1 , Linda S Hynan  1 , John Hart  1 , C Munro Cullum  1
Affiliations

Traumatic brain injury history and progression from mild cognitive impairment to Alzheimer disease

Christian LoBue et al. Neuropsychology. 2018 May.

Abstract

Objective: To examine whether history of traumatic brain injury (TBI) is associated with more rapid progression from mild cognitive impairment (MCI) to Alzheimer's disease (AD).

Method: Data from 2,719 subjects with MCI were obtained from the National Alzheimer's Coordinating Center. TBI was categorized based on presence (TBI+) or absence (TBI-) of reported TBI with loss of consciousness (LOC) without chronic deficit occurring >1 year prior to diagnosis of MCI. Survival analyses were used to determine if a history of TBI predicted progression from MCI to AD up to 8 years. Random regression models were used to examine whether TBI history also predicted rate of decline on the Clinical Dementia Rating scale Sum of Boxes score (CDR-SB) among subjects who progress to AD.

Results: Across 8 years, TBI history was not significantly associated with progression from MCI to a diagnosis of AD in unadjusted (HR = 0.80; 95% CI [0.63, 1.01]; p = .06) and adjusted (p = .15) models. Similarly, a history of TBI was a nonsignificant predictor for rate of decline on CDR-SB among subjects who progressed to AD (b = 0.15, p = .38). MCI was, however, diagnosed a mean of 2.6 years earlier (p < .001) in TBI+ subjects compared with the TBI- group.

Conclusions: A history of TBI with LOC was not associated with progression from MCI to AD, but was linked to an earlier age of MCI diagnosis. These findings add to a growing literature suggesting that TBI might reduce the threshold for onset of MCI and certain neurodegenerative conditions, but appears unrelated to progression from MCI to AD. (PsycINFO Database Record

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Figures

Figure 1
Figure 1
Flowchart of sample selection from NACC’s UDS dataset. MCI = mild cognitive impairment; AD = Alzheimer disease; F-U = follow up visits; TBI = traumatic brain injury with loss of consciousness.
Figure 2
Figure 2
Survival curve for progressing from MCI to AD in subjects with and without a history of TBI over 8 years. MCI = mild cognitive impairment; AD = Alzheimer disease; TBI+ = subjects with a history of traumatic brain injury with loss of consciousness.
Figure 3
Figure 3
Timeline of progression from MCI to AD for subjects with and without a history of TBI. MCI = age of diagnosis of mild cognitive impairment; AD = age of diagnosis of Alzheimer disease; TBI+ = a history of traumatic brain injury with loss of consciousness.
See this image and copyright information in PMC

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