Fall‐related brain injuries and the risk of dementia in elderly people: a population‐based study

Luukinen, Heikki; Viramo, Petteri; Herala, M.; Kervinen, Kari; Ya, Kesäniemi; Savola, Olli; Winqvist, Satu; Jokelainen, Jari; Hillbom, Matti

doi:10.1111/j.1468-1331.2004.00953.x

Cited by 51 publications

(30 citation statements)

References 57 publications

(105 reference statements)

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“…Moreover, time since TBI, duration of loss of consciousness, multiple TBI and APOE-4 allele status did not influence the risk of dementia. Luukinen et al (2005) carried out a population-based study that included 325 individuals aged 70 years or older with an initial MMSE score greater than 27. During a 9-year follow-up period, eight individuals had a TBI and 34 individuals developed dementia.…”

Section: Prospective Studiesmentioning

confidence: 99%

Dementia after traumatic brain injury

Starkstein

Jorge

2005

Int. Psychogeriatr.

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Early retrospective studies suggested that individuals with a history of a traumatic brain injury (TBI) had a higher risk for dementia than those without a history of TBI. Two meta-analyses demonstrated that the risk for dementia is higher among men, but not women, with a history of TBI. More recent prospective studies, however, are providing discrepant findings, probably due to important methodological differences. TBI is usually associated with significant neuropsychological deficits, primarily in the domains of attention, executive functioning and memory. These deficits may not improve with time. TBI may also lower the threshold for the clinical expression of dementia among predisposed individuals, and the onset of Alzheimer's disease (AD)-like neuropathological and biochemical changes immediately after severe TBI may play an important role in this mechanism.

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Section: Prospective Studiesmentioning

confidence: 99%

Dementia after traumatic brain injury

Starkstein

Jorge

2005

Int. Psychogeriatr.

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“…Head injury in non-APOE ε4 carriers did not increase risk. Luukinen et al found fall-related TBI to predict earlier onset of dementia, particularly in APOE ε4 carriers [52], and Friedman et al found APOE ε4 carriers with TBI had significantly poorer functional outcome [53]. However, there are also many mixed findings with respect to the relationship between APOE genotype and TBI.…”

Section: Tbi and Apoe ε4 Allele: Increased Vulnerability For Dementiamentioning

confidence: 99%

Sleep apnea, apolipoprotein epsilon 4 allele, and TBI: Mechanism for cognitive dysfunction and development of dementia

O’Hara¹,

Luzon²,

Hubbard³

et al. 2009

JRRD

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Abstract-Sleep apnea is prevalent among patients with traumatic brain injuries (TBIs), and initial studies suggest it is associated with cognitive impairments in these patients. Recent studies found that the apolipoprotein epsilon 4 (APOE epsilon 4) allele increases the risk for sleep disordered breathing, particularly sleep apnea. The APOE epsilon 4 allele is associated with cognitive decline and the development of dementia in the general population as well as in patients with TBI. These findings raise the question of whether patients with TBI who are APOE epsilon 4 allele carriers are more vulnerable to the negative effects of sleep apnea on their cognitive functioning. While few treatments are available for cognitive impairment, highly effective treatments are available for sleep apnea. Here we review these different lines of evidence, making a case that the interactive effects of sleep apnea and the APOE epsilon 4 allele represent an important mechanism by which patients with TBI may develop a range of cognitive and neurobehavioral impairments. Increased understanding of the relationships among sleep apnea, the APOE epsilon 4 allele, and cognition could improve our ability to ameliorate one significant source of cognitive impairment and risk for dementia associated with TBI.

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“…(Table 12) There was some evidence suggesting an interaction between ApoE and head injury increases dementia risk. Two longitudinal cohort studies and one case-controlled study found that the two to five-fold increased risk of any dementia or AD associated with head injury that was traumatic, severe or of unspecified severity was only in individuals positive for the ApoE e4 allele (Luukinen et al, 2008(Luukinen et al, , 2005Sundstrom et al, 2007;Tang et al, 1996b). One crosssectional and one case-controlled study did not find a significant interaction, however examination of the odds ratios suggests a trend towards greater effect of head injury on dementia in persons positive for ApoE e4 (O'Meara et al, 1997b;Plassman et al, 2000).…”

Section: Dietmentioning

confidence: 98%