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The association of traumatic brain injury with rate of progression of cognitive and functional impairment in a population-based cohort of Alzheimer's disease: the Cache County Dementia Progression Study*

Published online by Cambridge University Press:  15 May 2014

Mac Gilbert ,
Christine Snyder ,
Chris Corcoran ,
Maria C. Norton ,
Constantine G. Lyketsos  and
JoAnn T. Tschanz
Mac Gilbert
Affiliation:
Department of Psychology, Utah State University, Logan, Utah, USA
Christine Snyder
Affiliation:
Department of Psychology, Utah State University, Logan, Utah, USA
Chris Corcoran
Affiliation:
Department of Mathematics and Statistics, Utah State University, Logan, Utah, USA Center for Epidemiological Studies, Utah State University, Logan, Utah, USA
Maria C. Norton
Affiliation:
Department of Psychology, Utah State University, Logan, Utah, USA Center for Epidemiological Studies, Utah State University, Logan, Utah, USA Department of Family, Consumer, and Human Development, Utah State University, Logan, Utah, USA
Constantine G. Lyketsos
Affiliation:
Department of Psychiatry, Johns Hopkins Bayview Medical Center, Baltimore, Maryland, USA
JoAnn T. Tschanz*
Affiliation:
Department of Psychology, Utah State University, Logan, Utah, USA Center for Epidemiological Studies, Utah State University, Logan, Utah, USA
*
Correspondence should be addressed to: Dr JoAnn T. Tschanz, PhD, Center for Epidemiologic Studies, Utah State University, 4450 Old Main Hill, Logan 84322-4450, UT, USA. Phone: +1-435-797-1583. Email: joann.tschanz@usu.edu.
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Abstract

Background:

There is limited research on factors that influence the rate of progression in Alzheimer's disease (AD). A history of traumatic brain injury (TBI) is associated with an increased risk for AD, but its role on the rate of dementia progression after the onset of AD has not been examined.

Methods:

A population-based cohort of 325 persons with incident AD was followed for up to 11 years. The sample was 65% female with a mean (SD) age of dementia onset = 84.4 (6.4) years. History of TBI was categorized as number, severity (with or without loss of consciousness), and timing in relation to dementia onset (within ten years or more than ten years). Cognition was assessed by the Consortium to Establish a Registry of AD battery, and functional ability was assessed by the Clinical Dementia Rating Sum of Boxes.

Results:

In linear mixed models, a history of TBI within ten years of onset showed faster progression of functional impairment (LR x2 = 10.27, p = 0.006), while those with TBI more than ten years before dementia onset had higher scores on a measure of list learning (β = 1.61, p = 0.003) and semantic memory (β = 0.75, p = 0.0035).

Conclusions:

History of TBI and its recency may be a useful factor to predict functional progression in the course of AD.

Keywords

traumatic brain injurydementia progressionfunctional abilityAlzheimer's disease
Type
Research Article
Information
International Psychogeriatrics , Volume 26 , Issue 10 , October 2014 , pp. 1593 - 1601
Copyright
Copyright © International Psychogeriatric Association 2014 

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Footnotes

*

Presented in preliminary form at the Alzheimer's Association International Conference in Vancouver, BC, Canada, 2012 and the International Neuropsychological Society Conference in Boston, MA in 2011.

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