Introduction: Traumatic brain injury (TBI) has been associated with a greater risk of developing Alzheimer’s disease (AD). Less is known about the clinical features of AD patients with TBI history. The objective of this study was to examine whether a history of TBI and specific injury characteristics are associated with differences in age of disease onset, cognitive features, and neuropsychiatric symptoms (NPSs) in AD patients. Methods: Biomarker-proven AD patients (CSF or amyloid PET) were selected from the Amsterdam Dementia Cohort. TBI events were classified by age at injury (TBI #x3c;25 or ≥25 years) and TBI severity (loss of consciousness, multiple events). Cognitive composite scores were calculated from results of a neuropsychological test battery. NPSs were assessed with the Neuropsychiatric Inventory Questionnaire (NPI-Q). Linear regression analyses were utilized to examine associations between TBI, TBI characteristics, and clinical outcome measures. Results: Among the 1,755 selected AD patients (mean age = 65.2 years), 166 (9.5%) had documented ≥1 TBI in their medical history. Overall, TBI history was not related to differences in age of disease onset, but age at injury #x3c;25 years old was associated with 2.3 years earlier age at symptom onset (B = −2.34, p = 0.031). No significant associations were found between TBI history or TBI characteristics and differences in cognition or NPSs. Conclusion: Our results underscore previous findings on the vulnerability of the brain during critical maturation phases and suggest that an early TBI may contribute to lower resilience to neurodegenerative changes.
Dement Geriatr Cogn Disord Extra 2022;12:122–130

中文翻译：

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阿尔茨海默病患者的临床特征和脑外伤史

简介：创伤性脑损伤 (TBI) 与患阿尔茨海默病 (AD) 的风险增加有关。对于有 TBI 病史的 AD 患者的临床特征知之甚少。本研究的目的是检查 TBI 病史和特定损伤特征是否与 AD 患者发病年龄、认知特征和神经精神症状 (NPS) 的差异有关。方法：生物标志物证实的 AD 患者（CSF 或淀粉样蛋白 PET）选自阿姆斯特丹痴呆队列。TBI 事件按受伤年龄（TBI #x3c；25 或 ≥25 岁）和 TBI 严重程度（意识丧失、多起事件）分类。认知综合分数是根据神经心理学测试组的结果计算的。NPS 使用神经精神库存问卷 (NPI-Q) 进行评估。线性回归分析用于检查 TBI、TBI 特征和临床结果测量之间的关联。结果：在 1,755 名选定的 AD 患者（平均年龄 = 65.2 岁）中，166 名 (9.5%) 的病史中记录了≥1 次 TBI。总体而言，TBI 病史与发病年龄的差异无关，但受伤年龄#x3c；25 岁与发病年龄早 2.3 岁相关（B = -2.34，p = 0.031）。TBI 病史或 TBI 特征与认知或 NPS 差异之间未发现显着关联。结论：我们的研究结果强调了先前关于大脑在关键成熟阶段易受伤害的发现，并表明早期 TBI 可能有助于降低对神经退行性变化的恢复能力。
Dement Geriatr Cogn Disord Extra 2022;12:122–130