Traumatic brain injury alters neuropsychiatric symptomatology in all‐cause dementia

Abstract

Introduction Traumatic brain injury (TBI) may alter the course of neuropsychiatric symptom (NPS) onset during dementia development. The connection among TBI, NPS, and dementia progression is of increasing interest to researchers and clinicians. Methods Incidence of NPS was examined in participants with normal cognition who progressed to all‐cause dementia based on whether TBI history was present (n = 130) or absent (n = 849). Survival analyses were used to examine NPS incidence across 7.6 ± 3.0 years of follow‐up. Results Participants with TBI history had increased prevalence and incidence of apathy (44.7% vs 29.9%, P = .0062; HRadj. = 1.708, P = .0018) and motor disturbances (17.2% vs 9.5%, P = .0458; HRadj. = 2.023, P = .0168), controlling for demographics and type of dementia diagnosis. Earlier anxiety onset was associated with TBI (692 days prior to dementia diagnosis vs 161 days, P = .0265). Discussion History of TBI is associated with increased risk for and earlier onset of NPS in the trajectory of dementia development.

Effect of Weight Class on Regional Brain Volume, Cognition, and Other Neuropsychiatric Outcomes among Professional Fighters

“…[1][2][3] As such, it is unsurprising that TBI has been observed to influence neuropsychiatric functioning in the context of neurodegeneration, affecting both symptomatic presentation and clinician evaluation of patients. 4,5 In the context of contact sports, multiple authors have noted neurodegenerative changes due to TBI with accompanying neuropsychiatric deficits, such as those observed in chronic traumatic encephalopathy (CTE). [6][7][8] Although some of the earliest evidence of this was observed in combat sports such as boxing, 9,10 similar neurological effects of repetitive head impacts (RHIs) have been observed in military personnel and athletes playing football, soccer, and hockey.…”

Clinical Features of Patients with Alzheimer’s Disease and a History of Traumatic Brain Injury

“…Other studies have found no association between TBI history and faster cognitive decline or progression from MCI to dementia in AD patients [ 54 , 55 ]. Regarding NPSs, only two studies demonstrated that TBI history was associated with an elevated risk for disinhibition, apathy, and aberrant motor symptoms, yet this was found in an all-type dementia population [ 27 , 28 ]. Our findings may suggest that TBI is a risk factor for AD but may not alter clinical features once the disease has been developed.…”

Early Aβ42 Exposure Causes Learning Impairment in Later Life

“…A study from military veterans shows that TBI increases the risk of having Parkinson’s disease by approximately 56% [ 48 ]. Although a number of studies have demonstrated a transient increase of Aβ accumulation in the region of brain injury [ 5 , 49 ], the effect of early Aβ accumulation in the late development of neurodegeneration and dementia is largely unknown. Results of the current study confirmed that early-transient Aβ expression/ accumulation promotes the development of learning and memory deficits together with cell death in later life, partially resembling the situations of having TBI in humans.…”

“…Traumatic brain injury (TBI) has been proposed as one of the risking factors for AD [ 3 , 4 ]. Early TBI experience increases the chance of developing dementia in later life [ 5 ]. In addition, it has been shown that TBI increases acute Aβ accumulation in the region of injury, suggesting a possible cause-effect relationship between the early Aβ accumulation and the late dementia occurrence [ 6 , 7 ].…”