Bray Michael J C, Richey Lisa N, Bryant Barry R, Krieg Akshay, Jahed Sahar, Tobolowsky William, LoBue Christian, Peters Matthew E
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Alzheimers Dement. 2021 Apr;17(4):686-691. doi: 10.1002/alz.12225. Epub 2021 Jan 19.
Traumatic brain injury (TBI) may alter the course of neuropsychiatric symptom (NPS) onset during dementia development. The connection among TBI, NPS, and dementia progression is of increasing interest to researchers and clinicians.
Incidence of NPS was examined in participants with normal cognition who progressed to all-cause dementia based on whether TBI history was present (n = 130) or absent (n = 849). Survival analyses were used to examine NPS incidence across 7.6 ± 3.0 years of follow-up.
Participants with TBI history had increased prevalence and incidence of apathy (44.7% vs 29.9%, P = .0062; HR = 1.708, P = .0018) and motor disturbances (17.2% vs 9.5%, P = .0458; HR = 2.023, P = .0168), controlling for demographics and type of dementia diagnosis. Earlier anxiety onset was associated with TBI (692 days prior to dementia diagnosis vs 161 days, P = .0265).
History of TBI is associated with increased risk for and earlier onset of NPS in the trajectory of dementia development.
创伤性脑损伤（TBI）可能会改变痴呆症发展过程中神经精神症状（NPS）的发病进程。TBI、NPS与痴呆症进展之间的联系越来越受到研究人员和临床医生的关注。
根据是否有TBI病史（n = 130）或无TBI病史（n = 849），对进展为全因性痴呆的认知正常参与者的NPS发病率进行了检查。生存分析用于检查7.6±3.0年随访期间的NPS发病率。
有TBI病史的参与者，在控制人口统计学和痴呆症诊断类型后，冷漠的患病率和发病率增加（44.7%对29.9%，P = 0.0062；HR = 1.708，P = 0.0018）以及运动障碍（17.2%对9.5%，P = 0.0458；HR = 2.023，P = 0.0168）。较早的焦虑发作与TBI有关（痴呆症诊断前692天对161天，P = 0.0265）。
TBI病史与痴呆症发展轨迹中NPS的风险增加和发病较早有关。
