title: Clinical phenotype of dementia after traumatic brain injury.
abstract: Traumatic brain injury (TBI) in early to mid-life is associated with an increased risk of dementia in late life. It is unclear whether TBI results in acceleration of Alzheimer's disease (AD)-like pathology or has features of another dementing condition, such as chronic traumatic encephalopathy, which is associated with more-prominent mood, behavior, and motor disturbances than AD. Data from the National Alzheimer's Coordinating Center (NACC) Uniform Data Set was obtained over a 5-year period. Categorical data were analyzed using Fisher's exact test. Continuous parametric data were analyzed using the Student's t-test. Nonparametric data were analyzed using Mann-Whitney's test. Overall, 877 individuals with dementia who had sustained TBI were identified in the NACC database. Only TBI with chronic deficit or dysfunction was associated with increased risk of dementia. Patients with dementia after TBI (n=62) were significantly more likely to experience depression, anxiety, irritability, and motor disorders than patients with probable AD. Autopsy data were available for 20 of the 62 TBI patients. Of the patients with TBI, 62% met National Institute of Aging-Reagan Institute "high likelihood" criteria for AD. We conclude that TBI with chronic deficit or dysfunction is associated with an increased odds ratio for dementia. Clinically, patients with dementia associated with TBI were more likely to have symptoms of depression, agitation, irritability, and motor dysfunction than patients with probable AD. These findings suggest that dementia in individuals with a history of TBI may be distinct from AD.
authors: Department of Neurology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
authors: Nasreen
authors: N
authors: Sayed
authors: Carlee
authors: C
authors: Culver
authors: Kristen
authors: K
authors: Dams-O'Connor
authors: Flora
authors: F
authors: Hammond
authors: Ramon
authors: R
authors: Diaz-Arrastia
mesh_terms: D000368:Aged; D020208:Brain Injury, Chronic / Q000150:complications* / Q000473:pathology; D003704:Dementia / Q000209:etiology* / Q000473:pathology / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010641:Phenotype
references: Brain. 2013 Jan;136(Pt 1):43-64
references: 23208308
references: J Neuropathol Exp Neurol. 2009 Jul;68(7):709-35
references: 19535999
references: Alzheimer Dis Assoc Disord. 2004 Oct-Dec;18(4):270-7
references: 15592144
references: Neurology. 2000 Mar 28;54(6):1316-23
references: 10746604
references: Neurology. 2003 Sep 9;61(5):661-7
references: 12963758
references: Arch Neurol. 2012 Oct;69(10):1245-51
references: 22776913
references: Neuropsychopharmacology. 2012 Jan;37(1):261-77
references: 21937983
references: Alzheimer Dis Assoc Disord. 2006 Oct-Dec;20(4):210-6
references: 17132964
references: J Head Trauma Rehabil. 1999 Dec;14(6):602-15
references: 10671706
references: Psychol Med. 1973 Aug;3(3):270-303
references: 4729191
references: Arch Neurol. 2011 Dec;68(12):1526-35
references: 21825215
references: Neurology. 1984 Jul;34(7):939-44
references: 6610841
references: J Neurol Neurosurg Psychiatry. 2003 Jul;74(7):857-62
references: 12810767
references: Neurology. 2000 Oct 24;55(8):1158-66
references: 11071494