Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France, and Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Barcelona, Spain (Dr Jacob); Department of Physical Medicine and Rehabilitation, Raymond Poincaré Hospital, Garches, France, and EA4047, UFR des Sciences de la Santé, Université Versailles Saint-Quentin-en-Yvelines, "Handi-Resp," Simone Veil, France (Dr Azouvi); and Epidemiology, IQVIA, Frankfurt, Germany (Dr Kostev).
J Head Trauma Rehabil. 2021;36(3):E139-E146. doi: 10.1097/HTR.0000000000000624.
To investigate age-related changes in the association between traumatic brain injury (TBI) and dementia in older men and women separately.
A total of 243 general practices in the UK.
This study included 4760 patients who received a first TBI diagnosis between 1995 and 2010 (index date), and 4760 patients without TBI who were matched to those with TBI by age, sex, index year, Charlson Comorbidity Index, alcohol dependence, and physician (index date: a randomly selected visit date).
Retrospective cohort study.
Incidence of dementia in the decade following index date.
Within 10 years of index date, 8.8% of men with TBI and 4.8% of those without TBI were diagnosed with dementia, while the respective figures were 9.0% and 6.7% in women (P values < .01). There was a significant association between TBI and dementia in men (hazard ratio [HR] = 2.29, 95% confidence interval [CI]: 1.64-3.19) and in women (HR = 1.33, 95% CI: 1.07-1.64). Furthermore, the association between TBI and dementia was significant in men aged 60 to 70 (HR = 2.51, 95% CI: 1.27-4.96) and 71 to 80 years (HR = 3.00, 95% CI: 1.82-4.93), whereas the relationship was only significant and potentially unreliable in women aged 81 to 90 years (HR = 1.49, 95% CI: 1.03-2.14).
The age-related relationship between TBI and dementia differed between men and women. More research of a prospective nature and including behavioral data is needed to better understand these differences.
分别研究创伤性脑损伤（TBI）与老年男性和女性痴呆之间的关联随年龄变化的情况。
英国共有 243 家全科诊所。
本研究纳入了 1995 年至 2010 年间首次诊断为 TBI 的 4760 名患者（索引日期），以及 4760 名未发生 TBI 的患者，这些患者通过年龄、性别、索引年份、Charlson 合并症指数、酒精依赖和医生（索引日期：随机选择的就诊日期）与 TBI 患者相匹配。
回顾性队列研究。
索引日期后 10 年内痴呆的发病率。
在索引日期后的 10 年内，8.8%的 TBI 男性和 4.8%的无 TBI 男性被诊断为痴呆，而女性的相应比例分别为 9.0%和 6.7%（P 值均<0.01）。TBI 与男性（风险比[HR] = 2.29，95%置信区间[CI]：1.64-3.19）和女性（HR = 1.33，95% CI：1.07-1.64）痴呆之间存在显著关联。此外，TBI 与痴呆之间的关联在 60 至 70 岁（HR = 2.51，95% CI：1.27-4.96）和 71 至 80 岁（HR = 3.00，95% CI：1.82-4.93）的男性中具有显著意义，但在 81 至 90 岁的女性中仅具有显著意义且可能不可靠（HR = 1.49，95% CI：1.03-2.14）。
TBI 与痴呆之间的年龄相关性在男性和女性之间存在差异。需要更多前瞻性的、包含行为数据的研究来更好地理解这些差异。
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