Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.
Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.
Alzheimers Dement. 2023 Jan;19(1):217-225. doi: 10.1002/alz.12671. Epub 2022 Mar 28.
The impact of life-course traumatic brain injury (TBI) on dementia is unclear.
Within the Swedish Twin Registry (STR), 35,312 dementia-free twins were followed for up to 18 years. TBI history was identified via medical records. Data were analyzed using generalized estimating equation (GEE) and conditional logistic regression.
In multi-adjusted GEE models, the odds ratio (OR, 95% confidence interval [CI]) of dementia was 1.27 (1.03-1.57) for TBI at any age, 1.55 (1.04-2.31) for TBI at 50 to 59 years, and 1.67 (1.12-2.49) for TBI at 60 to 69 years. Cardiometabolic diseases (CMDs) increased dementia risk associated with TBI at age 50 to 69 years. The ORs in GEE and conditional logistic regression did not differ significantly (P = .37).
TBI, especially between ages 50 and 69 years, is associated with an increased risk of dementia, and this is exacerbated among people with CMDs. Genetic and early-life environmental factors may not account for the TBI-dementia association.
一生中创伤性脑损伤(TBI)对痴呆的影响尚不清楚。
在瑞典双胞胎登记处(STR)中,对 35312 名无痴呆的双胞胎进行了长达 18 年的随访。通过医疗记录确定 TBI 病史。使用广义估计方程(GEE)和条件逻辑回归进行数据分析。
在多因素调整的 GEE 模型中,任何年龄发生 TBI 的痴呆症的比值比(OR,95%置信区间[CI])为 1.27(1.03-1.57),50 至 59 岁发生 TBI 的 OR 为 1.55(1.04-2.31),60 至 69 岁发生 TBI 的 OR 为 1.67(1.12-2.49)。心血管代谢疾病(CMD)增加了与 50 至 69 岁 TBI 相关的痴呆症风险。GEE 和条件逻辑回归中的 OR 差异无统计学意义(P =.37)。
TBI,特别是在 50 至 69 岁之间,与痴呆风险增加相关,而在患有 CMD 的人群中,这种风险更为加剧。遗传和早期环境因素可能不能解释 TBI-痴呆症的关联。