Neuropsychiatric Symptoms in Dementia Patients With and Without a History of Traumatic Brain Injury

Abstract

The authors aim to determine if a history of traumatic brain injury (TBI) assessed before dementia onset is associated with a higher risk of neuropsychiatric symptoms after dementia onset. A population-based incident series of people with dementia were assessed for TBI prior to onset of dementia and for neuropsychiatric symptoms after the onset, using the Neuropsychiatric Inventory. Participants with predementia TBI were more likely to exhibit disinhibition (12.7% versus 5.4%, OR=2.8, p=0.02), but not other neuropsychiatric symptoms. Traumatic brain injury may increase the risk of disinhibition in patients with dementia.

Traumatic brain injury (TBI) in older adults: aging with a TBI versus incident TBI in the aged

“…Data from the National Alzheimer's Coordinating Center (NACC) suggest that TBI may be a risk factor for early-onset Alzheimer's disease (AD; onset <65 years) (Mendez et al , 2015) and that disinhibition is more likely to occur in those with AD who have a history of TBI. This association between pre-dementia TBI and disinhibition has been shown previously (Rao et al , 2010). However, in a recent meta-analysis, no statistically significant association was found between TBI and mild cognitive impairment or AD (Crane et al , 2016).…”

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

“…A prior report in Cache County found that history of TBI was associated with increased risk of disinhibition after the onset of AD (Rao, et al , 2010). We now add that there is risk of greater functional decline in AD, at least for those with a history of TBI that occurred relatively close in time to the onset of dementia.…”

“…Specifically, those who had a TBI prior to the onset of dementia were almost three times more likely to display the symptom of disinhibition, than those who did not have a history of TBI (Rao, et al , 2010). Data from animal models also suggest a plausible association of TBI with AD progression.…”

Long-Term Neuropsychiatric Disorders After Traumatic Brain Injury

“…Long-term studies have shown that, in a proportion of patients, cognitive functions continue to improve or deteriorate for many years after the injury (Hammond et al 2004;Millar et al 2003). TBI may increase the risk of disinhibition in patients with dementia (Rao et al 2010).…”