Jeff Schaffert, Hsueh-Sheng Chiang, Hudaisa Fatima, Christian LoBue, John Hart, C Munro Cullum
{"title":"创伤性脑损伤史不会改变有或没有认知障碍的老年人神经认知能力下降的过程。","authors":"Jeff Schaffert, Hsueh-Sheng Chiang, Hudaisa Fatima, Christian LoBue, John Hart, C Munro Cullum","doi":"10.1037/neu0000892","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Traumatic brain injury (TBI) history is associated with dementia risk, but it is unclear whether TBI history significantly hastens neurocognitive decline in older adults.</p><p><strong>Method: </strong>Data were derived from the National Alzheimer's Coordinating Center (NACC) data set. Participants with a history of TBI (TBI +; <i>n</i> = 1,467) were matched to individuals without a history of TBI (TBI-; <i>n</i> = 1,467) based on age (50-97, <i>M</i> = 71.61, <i>SD</i> = 8.40), sex, education, race, ethnicity, cognitive diagnosis, functional decline, number of Apolipoprotein ε4 (APOE ε4) alleles, and number of annual visits (3-6). Mixed linear models were used to assess longitudinal neuropsychological test composite scores of executive functioning/attention/speed, language, and memory in TBI + and TBI- participants. Interactions between TBI and demographics, APOE ε4 status, and cognitive diagnosis were also examined.</p><p><strong>Results: </strong>Longitudinal neuropsychological functioning did not differ between TBI groups (<i>p</i>'s > .001). There was a significant three-way interaction (age, TBI history, time) in language (<i>F</i>[20, 5750.1] = 3.133, <i>p</i> < .001) and memory performance (<i>F</i>[20, 6580.8] = 3.386, <i>p</i> < .001), but post hoc analyses revealed TBI history was not driving this relationship (all <i>p</i>'s > .096). No significant interactions were observed between TBI history and sex, education, race/ethnicity, number of APOE ε4 alleles, or cognitive diagnosis (<i>p</i>'s > .001).</p><p><strong>Conclusions: </strong>Findings suggest TBI history, regardless of demographic factors, APOE ε4 status, or cognitive diagnosis, does not alter the course of neurocognitive functioning later-in-life in older adults with or without cognitive impairment. Future clinicopathological longitudinal studies that well-characterize head injuries and the associated clinical course are needed to help clarify the mechanism in which TBI may increase dementia risk. (PsycInfo Database Record (c) 2023 APA, all rights reserved).</p>","PeriodicalId":19205,"journal":{"name":"Neuropsychology","volume":" ","pages":"923-932"},"PeriodicalIF":2.6000,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10556197/pdf/","citationCount":"0","resultStr":"{\"title\":\"History of traumatic brain injury does not alter course of neurocognitive decline in older adults with and without cognitive impairment.\",\"authors\":\"Jeff Schaffert, Hsueh-Sheng Chiang, Hudaisa Fatima, Christian LoBue, John Hart, C Munro Cullum\",\"doi\":\"10.1037/neu0000892\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Traumatic brain injury (TBI) history is associated with dementia risk, but it is unclear whether TBI history significantly hastens neurocognitive decline in older adults.</p><p><strong>Method: </strong>Data were derived from the National Alzheimer's Coordinating Center (NACC) data set. Participants with a history of TBI (TBI +; <i>n</i> = 1,467) were matched to individuals without a history of TBI (TBI-; <i>n</i> = 1,467) based on age (50-97, <i>M</i> = 71.61, <i>SD</i> = 8.40), sex, education, race, ethnicity, cognitive diagnosis, functional decline, number of Apolipoprotein ε4 (APOE ε4) alleles, and number of annual visits (3-6). Mixed linear models were used to assess longitudinal neuropsychological test composite scores of executive functioning/attention/speed, language, and memory in TBI + and TBI- participants. Interactions between TBI and demographics, APOE ε4 status, and cognitive diagnosis were also examined.</p><p><strong>Results: </strong>Longitudinal neuropsychological functioning did not differ between TBI groups (<i>p</i>'s > .001). There was a significant three-way interaction (age, TBI history, time) in language (<i>F</i>[20, 5750.1] = 3.133, <i>p</i> < .001) and memory performance (<i>F</i>[20, 6580.8] = 3.386, <i>p</i> < .001), but post hoc analyses revealed TBI history was not driving this relationship (all <i>p</i>'s > .096). No significant interactions were observed between TBI history and sex, education, race/ethnicity, number of APOE ε4 alleles, or cognitive diagnosis (<i>p</i>'s > .001).</p><p><strong>Conclusions: </strong>Findings suggest TBI history, regardless of demographic factors, APOE ε4 status, or cognitive diagnosis, does not alter the course of neurocognitive functioning later-in-life in older adults with or without cognitive impairment. Future clinicopathological longitudinal studies that well-characterize head injuries and the associated clinical course are needed to help clarify the mechanism in which TBI may increase dementia risk. (PsycInfo Database Record (c) 2023 APA, all rights reserved).</p>\",\"PeriodicalId\":19205,\"journal\":{\"name\":\"Neuropsychology\",\"volume\":\" \",\"pages\":\"923-932\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2023-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10556197/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Neuropsychology\",\"FirstCategoryId\":\"102\",\"ListUrlMain\":\"https://doi.org/10.1037/neu0000892\",\"RegionNum\":3,\"RegionCategory\":\"心理学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/4/6 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"NEUROSCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neuropsychology","FirstCategoryId":"102","ListUrlMain":"https://doi.org/10.1037/neu0000892","RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/4/6 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"NEUROSCIENCES","Score":null,"Total":0}
History of traumatic brain injury does not alter course of neurocognitive decline in older adults with and without cognitive impairment.
Objective: Traumatic brain injury (TBI) history is associated with dementia risk, but it is unclear whether TBI history significantly hastens neurocognitive decline in older adults.
Method: Data were derived from the National Alzheimer's Coordinating Center (NACC) data set. Participants with a history of TBI (TBI +; n = 1,467) were matched to individuals without a history of TBI (TBI-; n = 1,467) based on age (50-97, M = 71.61, SD = 8.40), sex, education, race, ethnicity, cognitive diagnosis, functional decline, number of Apolipoprotein ε4 (APOE ε4) alleles, and number of annual visits (3-6). Mixed linear models were used to assess longitudinal neuropsychological test composite scores of executive functioning/attention/speed, language, and memory in TBI + and TBI- participants. Interactions between TBI and demographics, APOE ε4 status, and cognitive diagnosis were also examined.
Results: Longitudinal neuropsychological functioning did not differ between TBI groups (p's > .001). There was a significant three-way interaction (age, TBI history, time) in language (F[20, 5750.1] = 3.133, p < .001) and memory performance (F[20, 6580.8] = 3.386, p < .001), but post hoc analyses revealed TBI history was not driving this relationship (all p's > .096). No significant interactions were observed between TBI history and sex, education, race/ethnicity, number of APOE ε4 alleles, or cognitive diagnosis (p's > .001).
Conclusions: Findings suggest TBI history, regardless of demographic factors, APOE ε4 status, or cognitive diagnosis, does not alter the course of neurocognitive functioning later-in-life in older adults with or without cognitive impairment. Future clinicopathological longitudinal studies that well-characterize head injuries and the associated clinical course are needed to help clarify the mechanism in which TBI may increase dementia risk. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
期刊介绍：
Neuropsychology publishes original, empirical research; systematic reviews and meta-analyses; and theoretical articles on the relation between brain and human cognitive, emotional, and behavioral function.
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