TBI is increasingly recognized as a major risk factor for developing neurocognitive disorders, triggering neurodegeneration through various mechanisms, Dr. Elaine de Guise of the University of Montreal and colleagues note in their report in Alzheimer Disease & Associated Disorders.
Determining risk factors for post-traumatic neurodegeneration in TBI patients is "critical given the high incidence of TBI," the team writes. They hypothesized that cardiovascular and metabolic comorbidities, in addition to TBI severity, would be associated with the risk of post-traumatic development of AD dementia.
Dr. de Guise and colleagues assessed risk factors for developing AD dementia after TBI in a case-controlled retrospective study using medical records and medical insurance data.
They identified 5,642 patients with mostly mild or moderate TBI admitted to a tertiary trauma center over 12 years and no previous dementia diagnosis. The analysis focused on 30 patients who developed AD dementia and 80 non-dementia controls.
Patients in the AD dementia group suffered TBI at a younger age than controls (median age at TBI, 58.3 years vs. 70.4 years). The median time to diagnosis of AD dementia after TBI was 3.3 years.
Age at the occurrence of TBI, years of schooling, previous TBI, past medical history, and initial Glasgow Coma Scale (GCS) score were not significantly associated with development of AD dementia after TBI.
In logistic-regression analysis, the presence of post-traumatic amnesia and chronic vascular lesions were significantly associated with development of AD dementia after TBI, with odds ratios of 2.88 and 3.81, respectively.
The researchers say their findings support the hypothesis that TBI may enhance the harmful effects of cerebral small-vessel disease (SVD), as chronic vascular lesions (indicative of SVD) were correlated to subsequent AD dementia.
They caution that this preliminary study is the first to explore risk factors for post-traumatic AD dementia.
Future studies assessing risk factors for a "broader array of dementias will be essential to further advance knowledge on this condition and optimize care for this ever-increasing population," they write.
SOURCE: https://bit.ly/3pXPXyB Alzheimer Disease & Associated Disorders, online December 30, 2021.
By Reuters Staff
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