Institute of Clinical Medicine, National Cheng Kung University, Tainan 704, Taiwan.
J Neurol Neurosurg Psychiatry. 2012 Nov;83(11):1080-5. doi: 10.1136/jnnp-2012-302633. Epub 2012 Jul 27.
The relationship between traumatic brain injury (TBI) and the risk of dementia remains controversial. This population based study was designed to estimate and compare the risk of dementia in TBI and non-TBI individuals during the 5 year period after TBI.
This study was a retrospective cohort study. Data were obtained from the Longitudinal Health Insurance Database 2000. We included 44,925 patients receiving ambulatory or hospital care and 224,625 non-TBI patients; patients were matched for sex, age and year of index use of healthcare. Patients <15 years of age and those admitted to the intensive care unit were excluded. Each individual was studied for 5 years to identify the subsequent development of dementia. Data were analysed by Cox proportional hazard regression.
During the 5 year follow-up period, 1196 TBI (2.66%) and 224,625 non-TBI patients (1.53%) patients developed dementia. During the 5 year follow-up period, TBI was independently associated with a 1.68 (range 1.57-1.80) times greater risk of dementia after adjusting for sociodemographic characteristics and selected comorbidities.
The findings of this study suggest an increased risk of dementia among individuals with TBI. We suggest the need for more intensive medical monitoring and health education in individuals with TBI.
创伤性脑损伤(TBI)与痴呆风险之间的关系仍存在争议。本基于人群的研究旨在估计和比较 TBI 和非 TBI 个体在 TBI 后 5 年内发生痴呆的风险。
本研究为回顾性队列研究。数据来自 2000 年纵向健康保险数据库。我们纳入了 44925 名接受门诊或住院治疗的患者和 224625 名非 TBI 患者;根据性别、年龄和医保索引使用年份对患者进行匹配。排除年龄<15 岁和入住重症监护病房的患者。每位患者随访 5 年,以确定随后发生痴呆的情况。采用 Cox 比例风险回归分析数据。
在 5 年的随访期间,1196 名 TBI(2.66%)和 224625 名非 TBI 患者(1.53%)患者发生了痴呆。在 5 年的随访期间,在调整社会人口特征和选定的合并症后,TBI 与痴呆风险增加 1.68 倍(范围 1.57-1.80)独立相关。
本研究的结果表明,TBI 个体发生痴呆的风险增加。我们建议需要对 TBI 个体进行更强化的医疗监测和健康教育。