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. 2019 Apr 29:11:355-367.
doi: 10.1016/j.dadm.2019.03.003. eCollection 2019 Dec.

Sex-specific incident dementia in patients with central nervous system trauma

Tatyana Mollayeva  1   2   3 , Mackenzie Hurst  2 , Michael Escobar  4 , Angela Colantonio  1   2   3
Affiliations

Sex-specific incident dementia in patients with central nervous system trauma

Tatyana Mollayeva et al. Alzheimers Dement (Amst). .

Abstract

Introduction: Despite evidence that central nervous system (CNS) trauma, including traumatic brain injury and spinal cord injury, can cause sustained neurocognitive impairment, it remains unclear whether trauma-related variables are associated with incident dementia independently of other known risk factors.

Methods: All adults without dementia entering the health-care system with diagnoses of CNS trauma were examined for occurrence of dementia. All trauma-related variables were examined as predictors in sex-specific Cox regression models, controlling for other known risk factors.

Results: Over a median follow-up of 52 months, 32,834 of 712,708 patients (4.6%) developed dementia. Traumatic brain injury severity and spinal cord injury interacted with age to influence dementia onset; women were at a greater risk of developing dementia earlier than men, all other factors being equal.

Discussion: Risk stratification of patients with CNS trauma by sex is vital in identifying those most likely to develop dementia and in understanding the course and modifying factors.

Keywords: Comorbidity; Dementia; Prognostic modeling; Risk factors; Spinal cord injury; Traumatic brain injury.

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Figures

Fig. 1
Fig. 1
Hypothesized relationships related to dementia outcome after central nervous system trauma. Red color indicates previously unexplored hypothesis. Black color indicates other tested relationships, previously described. *The following variables were evaluated as predictors in our statistical models: (1) TBI severity, (2) presence of comorbid SCI, (3) the interaction of TBI severity and age, and (4) the interaction of comorbid SCI and age. Abbreviations: SCI, spinal cord injury; TBI, traumatic brain injury.
Fig. 2
Fig. 2
(A) Proportional hazard ratio plots of the estimated risk of dementia versus patient age at first TBI event, and by TBI severity, after adjustment for sex and known risk factors. Mild TBI severity was used as a reference. (B) Proportional hazard ratio plots of the estimated risk of dementia versus patient age at first TBI event, and by TBI severity and by sex, after adjustment for known risk factors. Mild TBI severity was used as a reference. Abbreviations: F, female; M, male; TBI, traumatic brain injury.
Fig. 3
Fig. 3
(A) Proportional hazard ratio plots of the estimated risk of dementia versus patient age at first TBI event in the presence of comorbid SCI, after adjustment for sex and known risk factors. No SCI comorbidity was used as a reference. (B) Proportional hazard ratio plots of the estimated risk of dementia versus patient age at first TBI event in the presence of comorbid SCI, by sex, after adjustment for known risk factors. No SCI comorbidity was used as a reference. Abbreviations: F, female; M, male; TBI, traumatic brain injury; SCI, spinal cord injury.
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References

    1. Julien J., Joubert S., Ferland M.C., Frenette L.C., Boudreau-Duhaime M.M., Malo-Véronneau L. Association of traumatic brain injury and Alzheimer disease onset: A systematic review. Ann Phys Rehabil Med. 2017;60:347–356. - PubMed
    1. Maas A.I.R., Menon D.K., Adelson P.D., Andelic N., Bell M.J., Belli A., InTBIR Participants and Investigators Traumatic brain injury: integrated approaches to improve prevention, clinical care, and research. Lancet Neurol. 2017;16:987–1048. - PubMed
    1. Furlan J.C., Sakakibara B.M., Miller W.C., Krassioukov A.V. Global incidence and prevalence of traumatic spinal cord injury. Can J Neurol Sci. 2013;40:456–464. - PubMed
    1. Bombardier C.H., Lee D.C., Tan D.L., Barber J.K., Hoffman J.M. Comorbid Traumatic Brain Injury and Spinal Cord Injury: Screening Validity and Effect on Outcomes. Arch Phys Med Rehabil. 2016;97:1628–1634. - PubMed
    1. Tan X.L., Sun M., Brady R.D., Liu S., Llanos R., Cheung S. Transactive Response DNA-Binding Protein 43 Abnormalities after Traumatic Brain Injury. J Neurotrauma. 2018 [Epub ahead of print] - PubMed