Age-Related Changes in the Association Between Traumatic Brain Injury and Dementia in Older Men and Women.

OBJECTIVE To investigate age-related changes in the association between traumatic brain injury (TBI) and dementia in older men and women separately. SETTING A total of 243 general practices in the UK. PARTICIPANTS This study included 4760 patients who received a first TBI diagnosis between 1995 and 2010 (index date), and 4760 patients without TBI who were matched to those with TBI by age, sex, index year, Charlson Comorbidity Index, alcohol dependence, and physician (index date: a randomly selected visit date). DESIGN Retrospective cohort study. MAIN MEASURES Incidence of dementia in the decade following index date. RESULTS Within 10 years of index date, 8.8% of men with TBI and 4.8% of those without TBI were diagnosed with dementia, while the respective figures were 9.0% and 6.7% in women (P values < .01). There was a significant association between TBI and dementia in men (hazard ratio [HR] = 2.29, 95% confidence interval [CI]: 1.64-3.19) and in women (HR = 1.33, 95% CI: 1.07-1.64). Furthermore, the association between TBI and dementia was significant in men aged 60 to 70 (HR = 2.51, 95% CI: 1.27-4.96) and 71 to 80 years (HR = 3.00, 95% CI: 1.82-4.93), whereas the relationship was only significant and potentially unreliable in women aged 81 to 90 years (HR = 1.49, 95% CI: 1.03-2.14). CONCLUSIONS The age-related relationship between TBI and dementia differed between men and women. More research of a prospective nature and including behavioral data is needed to better understand these differences.

[1]  M. Myrskylä,et al.  The relationship between living arrangements and higher use of hospital care at middle and older ages: to what extent do observed and unobserved individual characteristics explain this association? , 2019, BMC Public Health.

[2]  M. Prince,et al.  Associations between Depression, Depressive Symptoms, and Incidence of Dementia in Latin America: A 10/66 Dementia Research Group Study , 2019, Journal of Alzheimer's disease : JAD.

[3]  C. Lyketsos,et al.  Nutritional Status is Associated With Severe Dementia and Mortality: The Cache County Dementia Progression Study , 2018, Alzheimer disease and associated disorders.

[4]  Junga Lee The Relationship Between Physical Activity and Dementia: A Systematic Review and Meta-Analysis of Prospective Cohort Studies. , 2018, Journal of gerontological nursing.

[5]  K. Yaffe,et al.  Association of Mild Traumatic Brain Injury With and Without Loss of Consciousness With Dementia in US Military Veterans , 2018, JAMA neurology.

[6]  J. Hart,et al.  Traumatic Brain Injury History and Progression from Mild Cognitive Impairment to Alzheimer Disease , 2018, Neuropsychology.

[7]  G. Manley,et al.  Cerebral blood vessel damage in traumatic brain injury. , 2018, Clinical biomechanics.

[8]  John Hart,et al.  Traumatic Brain Injury History Is Associated With an Earlier Age of Dementia Onset in Autopsy-Confirmed Alzheimer’s Disease , 2018, Neuropsychology.

[9]  A. Nordström,et al.  Traumatic brain injury and the risk of dementia diagnosis: A nationwide cohort study , 2018, PLoS medicine.

[10]  Y. A. Hong,et al.  Association between exercise and the risk of dementia: results from a nationwide longitudinal study in China , 2017, BMJ Open.

[11]  B. Dong,et al.  Association Between Nutrition Status and Cognitive Impairment Among Chinese Nonagenarians and Centenarians , 2017 .

[12]  V. Feigin,et al.  Years of life lost due to traumatic brain injury in Europe: A cross-sectional analysis of 16 countries , 2017, PLoS medicine.

[13]  L. Chin,et al.  Traumatic Brain Injury , 2017, Cell transplantation.

[14]  Xiaofeng Zhu,et al.  Head Injury as a Risk Factor for Dementia and Alzheimer’s Disease: A Systematic Review and Meta-Analysis of 32 Observational Studies , 2017, PloS one.

[15]  Xiaoting Liu,et al.  Changes in living arrangements and mortality among older people in China , 2016, SSM - population health.

[16]  A. Helmy,et al.  Traumatic brain injury in England and Wales: prospective audit of epidemiology, complications and standardised mortality , 2016, BMJ Open.

[17]  H. Dhaliwal,et al.  The International Incidence of Traumatic Brain Injury: A Systematic Review and Meta-Analysis , 2016, Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques.

[18]  R. Müri,et al.  Predictors of inpatient (neuro)rehabilitation after acute care of severe traumatic brain injury: An epidemiological study , 2016, Brain injury.

[19]  Paul M. Thompson,et al.  Age, APOE and sex: Triad of risk of Alzheimer’s disease , 2016, The Journal of Steroid Biochemistry and Molecular Biology.

[20]  C. Matthys,et al.  Risk Factors for Malnutrition in Older Adults: A Systematic Review of the Literature Based on Longitudinal Data. , 2016, Advances in nutrition.

[21]  Elena Kotyrlo,et al.  Marital status and risk of dementia: a nationwide population-based prospective study from Sweden , 2016, BMJ Open.

[22]  W. Chiu,et al.  Sex Differences in Working Memory after Mild Traumatic Brain Injury: A Functional MR Imaging Study. , 2015, Radiology.

[23]  Kristine Yaffe,et al.  Dementia risk after traumatic brain injury vs nonbrain trauma: the role of age and severity. , 2014, JAMA neurology.

[24]  K. Yaffe,et al.  Impact of sleep on the risk of cognitive decline and dementia , 2014, Current opinion in psychiatry.

[25]  H. Amièva,et al.  Cognitive decline after entering a nursing home: a 22-year follow-up study of institutionalized and noninstitutionalized elderly people. , 2014, Journal of the American Medical Directors Association.

[26]  Juhyun Song,et al.  Association between Risk Factors for Vascular Dementia and Adiponectin , 2014, BioMed research international.

[27]  Jeffrey P. Cuthbert,et al.  Traumatic brain injury among older adults at level I and II trauma centers. , 2013, Journal of neurotrauma.

[28]  Nic James,et al.  Age-related decrease in physical activity and functional fitness among elderly men and women , 2013, Clinical interventions in aging.

[29]  N. Watson,et al.  Traumatic brain injury and sleep disorders. , 2012, Neurologic clinics.

[30]  W. Katon,et al.  Health care costs associated with traumatic brain injury and psychiatric illness in adults. , 2012, Journal of neurotrauma.

[31]  S. Langan,et al.  Medical Record Databases , 2012 .

[32]  K. Yaffe,et al.  Traumatic brain injury and risk of dementia in older veterans , 2011, Alzheimer's & Dementia.

[33]  S. Dikmen,et al.  Rates of major depressive disorder and clinical outcomes following traumatic brain injury. , 2010, JAMA.

[34]  Douglas H. Smith,et al.  Traumatic brain injury and amyloid-β pathology: a link to Alzheimer's disease? , 2010, Nature Reviews Neuroscience.

[35]  B. Christensen,et al.  Examining moderators of cognitive recovery trajectories after moderate to severe traumatic brain injury. , 2008, Archives of physical medicine and rehabilitation.

[36]  Jason R. Freeman,et al.  Sex differences in outcome following sports-related concussion. , 2005, Journal of neurosurgery.

[37]  R. Hanks,et al.  Etiology of traumatic brain injury: characterization of differential outcomes up to 1 year postinjury. , 2003, Archives of physical medicine and rehabilitation.

[38]  W. Alves,et al.  Do women fare worse: a metaanalysis of gender differences in traumatic brain injury outcome. , 2000, Journal of neurosurgery.

[39]  J. Gold,et al.  Validation of a combined comorbidity index. , 1994, Journal of clinical epidemiology.

[40]  H. Sutton AN EPIDEMIOLOGICAL STUDY , 1937 .

[41]  Allen W. Brown,et al.  Risk Factors for Institutionalization After Traumatic Brain Injury Inpatient Rehabilitation , 2017, The Journal of head trauma rehabilitation.

[42]  M. Alosco,et al.  The Effect of Traumatic Brain Injury History with Loss of Consciousness on Rate of Cognitive Decline Among Older Adults with Normal Cognition and Alzheimer's Disease Dementia. , 2017, Journal of Alzheimer's disease : JAD.

[43]  J. Hart,et al.  Self-Reported Traumatic Brain Injury and Mild Cognitive Impairment: Increased Risk and Earlier Age of Diagnosis. , 2016, Journal of Alzheimer's disease : JAD.

[44]  K. Seal,et al.  Association between mild traumatic brain injury and mental health problems and self-reported cognitive dysfunction in Iraq and Afghanistan Veterans. , 2016, Journal of rehabilitation research and development.