Lisa N Richey, Nicholas O Daneshvari, Lisa Young, Michael J C Bray, Rebecca F Gottesman, Thomas Mosley, Keenan A Walker, Andrea L C Schneider, Matthew E Peters
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We investigated (1) if cross-sectional associations of cognitive status with MBI symptoms differ by TBI status and (2) if prospective associations of MBI domain positivity with incident dementia risk differ by TBI status.</p><p><strong>Methods: </strong>2246 participants without dementia from the Atherosclerosis Risk in Communities Study were included (mean age = 75.6 years, 59.0% female). TBI was defined by self-report/ICD-9/10 codes, MBI via an established algorithm based on the Neuropsychiatric Inventory Questionnaire, and baseline cognitive status/incident dementia using neuropsychological tests, informant interviews, and hospital/death certificate codes.</p><p><strong>Results: </strong>Cross-sectionally, although MCI status was associated with greater odds of MBI, this did not differ based on TBI status (MCI with TBI: OR = 2.04, 95% CI = 1.44-2.88, MCI without TBI: OR = 1.60, 95% CI = 1.20-2.14). Individuals with MCI (with or without TBI) were more likely to have decreased motivation, affective dysregulation, and impulse dyscontrol. Prospectively, positivity in 1+ MBI domains was associated with increased risk of incident dementia, not differing by TBI status (no TBI and MBI: HR = 2.15, 95% CI = 1.55-2.99, TBI and MBI: HR = 2.62, 95% CI = 1.81-3.80).</p><p><strong>Conclusions: </strong>Neither cross-sectional associations between cognitive status and MBI domain positivity nor prospective associations of MBI domain positivity with incident dementia risk differed by TBI status. How TBI may relate to neuropsychiatric symptomatology in the context of neurodegenerative processes requires further clarification.</p>","PeriodicalId":16028,"journal":{"name":"Journal of Geriatric Psychiatry and Neurology","volume":" ","pages":"8919887251317726"},"PeriodicalIF":2.9000,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Associations of Traumatic Brain Injury and Mild Behavioral Impairment With Cognitive Function and Dementia.\",\"authors\":\"Lisa N Richey, Nicholas O Daneshvari, Lisa Young, Michael J C Bray, Rebecca F Gottesman, Thomas Mosley, Keenan A Walker, Andrea L C Schneider, Matthew E Peters\",\"doi\":\"10.1177/08919887251317726\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Traumatic Brain Injury (TBI) may contribute additional complexity to the clinical picture of mild behavioral impairment (MBI). 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TBI was defined by self-report/ICD-9/10 codes, MBI via an established algorithm based on the Neuropsychiatric Inventory Questionnaire, and baseline cognitive status/incident dementia using neuropsychological tests, informant interviews, and hospital/death certificate codes.</p><p><strong>Results: </strong>Cross-sectionally, although MCI status was associated with greater odds of MBI, this did not differ based on TBI status (MCI with TBI: OR = 2.04, 95% CI = 1.44-2.88, MCI without TBI: OR = 1.60, 95% CI = 1.20-2.14). Individuals with MCI (with or without TBI) were more likely to have decreased motivation, affective dysregulation, and impulse dyscontrol. Prospectively, positivity in 1+ MBI domains was associated with increased risk of incident dementia, not differing by TBI status (no TBI and MBI: HR = 2.15, 95% CI = 1.55-2.99, TBI and MBI: HR = 2.62, 95% CI = 1.81-3.80).</p><p><strong>Conclusions: </strong>Neither cross-sectional associations between cognitive status and MBI domain positivity nor prospective associations of MBI domain positivity with incident dementia risk differed by TBI status. 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引用次数: 0
摘要
目的：外伤性脑损伤（TBI）可能使轻度行为障碍（MBI）的临床表现更加复杂。MBI是一种与轻度认知障碍（MCI）类似的行为，由五个神经精神领域组成：动机减少、情感失调、冲动失调、社交不当和异常的感知/思维内容。我们调查了(1)认知状态与MBI症状的横断面关联是否因TBI状态而异；(2)MBI结构域阳性与痴呆发生风险的前瞻性关联是否因TBI状态而异。方法：纳入2246名来自社区动脉粥样硬化风险研究的无痴呆参与者（平均年龄= 75.6岁，59.0%为女性）。TBI通过自我报告/ICD-9/10代码定义，MBI通过基于神经精神调查问卷的既定算法定义，基线认知状态/事件性痴呆通过神经心理测试、线人访谈和医院/死亡证明代码定义。结果：横断面上，虽然MCI状态与MBI的几率较大相关，但这并没有基于TBI状态的差异（伴有TBI的MCI: OR = 2.04, 95% CI = 1.44-2.88，无TBI的MCI: OR = 1.60, 95% CI = 1.20-2.14）。MCI患者（伴有或不伴有TBI）更有可能出现动机下降、情感失调和冲动控制障碍。前瞻性地，1+ MBI域的阳性与痴呆发生风险增加相关，与TBI状态无关（无TBI和MBI: HR = 2.15, 95% CI = 1.55-2.99， TBI和MBI: HR = 2.62, 95% CI = 1.81-3.80）。结论：认知状态与MBI结构域阳性的横断面关联以及MBI结构域阳性与痴呆发病风险的前瞻性关联均不因TBI状态而异。在神经退行性过程的背景下，创伤性脑损伤如何与神经精神症状学相关需要进一步澄清。
Associations of Traumatic Brain Injury and Mild Behavioral Impairment With Cognitive Function and Dementia.
Objective: Traumatic Brain Injury (TBI) may contribute additional complexity to the clinical picture of mild behavioral impairment (MBI). MBI, a behavioral analog to mild cognitive impairment (MCI), is comprised of five neuropsychiatric domains: decreased motivation, affective dysregulation, impulse dyscontrol, social inappropriateness, and abnormal perception/thought content. We investigated (1) if cross-sectional associations of cognitive status with MBI symptoms differ by TBI status and (2) if prospective associations of MBI domain positivity with incident dementia risk differ by TBI status.
Methods: 2246 participants without dementia from the Atherosclerosis Risk in Communities Study were included (mean age = 75.6 years, 59.0% female). TBI was defined by self-report/ICD-9/10 codes, MBI via an established algorithm based on the Neuropsychiatric Inventory Questionnaire, and baseline cognitive status/incident dementia using neuropsychological tests, informant interviews, and hospital/death certificate codes.
Results: Cross-sectionally, although MCI status was associated with greater odds of MBI, this did not differ based on TBI status (MCI with TBI: OR = 2.04, 95% CI = 1.44-2.88, MCI without TBI: OR = 1.60, 95% CI = 1.20-2.14). Individuals with MCI (with or without TBI) were more likely to have decreased motivation, affective dysregulation, and impulse dyscontrol. Prospectively, positivity in 1+ MBI domains was associated with increased risk of incident dementia, not differing by TBI status (no TBI and MBI: HR = 2.15, 95% CI = 1.55-2.99, TBI and MBI: HR = 2.62, 95% CI = 1.81-3.80).
Conclusions: Neither cross-sectional associations between cognitive status and MBI domain positivity nor prospective associations of MBI domain positivity with incident dementia risk differed by TBI status. How TBI may relate to neuropsychiatric symptomatology in the context of neurodegenerative processes requires further clarification.
期刊介绍：
Journal of Geriatric Psychiatry and Neurology (JGP) brings together original research, clinical reviews, and timely case reports on neuropsychiatric care of aging patients, including age-related biologic, neurologic, and psychiatric illnesses; psychosocial problems; forensic issues; and family care. The journal offers the latest peer-reviewed information on cognitive, mood, anxiety, addictive, and sleep disorders in older patients, as well as tested diagnostic tools and therapies.
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