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Traumatic brain injury and age at onset of cognitive impairment in older adults

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An Erratum to this article was published on 09 June 2016

Abstract

There is a deficiency of knowledge regarding how traumatic brain injury (TBI) is associated with age at onset (AAO) of cognitive impairment in older adults. Participants with a TBI history were identified from the Alzheimer's disease neuroimaging initiative (ADNI 1/GO/2) medical history database. Using an analysis of covariance (ANCOVA) model, the AAO was compared between those with and without TBI, and potential confounding factors were controlled. The AAO was also compared between those with mild TBI (mTBI) and moderate or severe TBI (sTBI). Lastly, the effects of mTBI were analyzed on the AAO of participants with clinical diagnoses of either mild cognitive impairment (MCI) or Alzheimer's disease (AD). The AAO for a TBI group was 68.2 ± 1.1 years [95 % confidence interval (CI) 66.2–70.3, n = 62], which was significantly earlier than the AAO for the non-TBI group of 70.9 ± 0.2 years (95 % CI 70.5–71.4, n = 1197) (p = 0.013). Participants with mTBI history showed an AAO of 68.5 ± 1.1 years (n = 56), which was significantly earlier than the AAO for the non-TBI group (p = 0.032). Participants with both MCI and mTBI showed an AAO of 66.5 ± 1.3 years (95 % CI 63.9–69.1, n = 45), compared to 70.6 ± 0.3 years for the non-TBI MCI group (95 % CI 70.1–71.1, n = 935) (p = 0.016). As a conclusion, a history of TBI may accelerate the AAO of cognitive impairment by two or more years. These results were consistent with reports of TBI as a significant risk factor for cognitive decline in older adults, and TBI is associated with an earlier AAO found in patients with MCI or AD.

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Acknowledgments

Data collection and sharing for this project was funded by the Alzheimer's Disease Neuroimaging Initiative (ADNI) (National Institutes of Health Grant U01 AG024904) and DOD ADNI (Department of Defense award number W81XWH-12-2-0012). Analyses in the present report were supported by NIA R01 AG19771 (to AJS), NIA K01 AG049050 (SLR), and funding from Indiana Alzheimer Disease Center.

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Authors and Affiliations

  1. School of Health and Rehabilitation Sciences, Indiana University Purdue University, 2039 N. Capitol Avenue, Indianapolis, IN, 46202, USA

    Wei Li

  2. Department of Radiology and Imaging Sciences, Center for Neuroimaging, Indiana Alzheimer Disease Center, Indiana University School of Medicine, 355 W. 16th Street, Suite 4100, Indianapolis, IN, 46202, USA

    Shannon L. Risacher & Andrew J. Saykin

  3. Department of Psychiatry, Indiana University School of Medicine, 355 W. 16th Street, Suite 4800, Indianapolis, IN, 46202, USA

    Thomas W. McAllister

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Correspondence to Wei Li.

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On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical Standard

All investigations were carried out according to the Declaration of Helsinki.

Informed consent

Written informed consent was obtained from all participants (or guardians of participants) participating in the study according to the Declaration of Helsinki (consent for research).

Additional information

For the Alzheimer's disease neuroimaging initiative.

Data used in the preparation of this article were obtained from the Alzheimer's disease neuroimaging initiative (ADNI) database (adni.loni.usc.edu). As such, the investigators within the ADNI contributed to the design and implementation of ADNI and/or provided data, but did not participate in the analysis or writing of this report. A complete listing of ADNI investigators can be found at: http://adni.loni.usc.edu/wp-content/uploads/how_to_apply/ADNI_Acknowledgement_List.pdf.

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Li, W., Risacher, S.L., McAllister, T.W. et al. Traumatic brain injury and age at onset of cognitive impairment in older adults. J Neurol 263, 1280–1285 (2016). https://doi.org/10.1007/s00415-016-8093-4

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  • DOI: https://doi.org/10.1007/s00415-016-8093-4

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