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Traumatic brain injury and young onset dementia: a nationwide cohort study.

Abstract

OBJECTIVE

To investigate the association between traumatic brain injuries (TBIs) and the risk of young onset dementia (YOD), that is, dementia before 65 years of age.

METHODS

The study cohort comprised 811,622 Swedish men (mean age 5 18 years) conscripted for military service between 1969 and 1986. TBIs, dementia, and covariates were extracted from national registers. Time-dependent exposures using Cox proportional hazard regression models were evaluated.

RESULTS

During a median follow-up period of 33 years, there were 45,249 men with at least 1 TBI in the cohort. After adjustment for covariates, 1 mild TBI (hazard ratio [HR] 5 1.0, 95% confidence interval [CI] 5 0.5–2.0), at least 2 mild TBIs (HR 5 2.5, 95% CI 5 0.8–8.1), or 1 severe TBI (HR 5 0.7, 95% CI 5 0.1–5.2) were not associated with Alzheimer dementia (AD). Other types of dementia were strongly associated with the risk of 1 mild TBI (HR 5 3.8, 95% CI 5 2.8–5.2), at least 2 mild TBIs (HR 5 10.4, 95% CI 5 6.3–17.2), and 1 severe TBI (HR 5 11.4, 95% CI 5 7.4–17.5) in age-adjusted analysis. However, these associations were largely attenuated after adjustment for covariates (1 mild TBI: HR 5 1.7; at least 2 mild TBIs: HR 5 1.7; 1 severe TBI: HR 5 2.6; p < 0.05 for all).

INTERPRETATION

In the present study, we found strong associations between YOD of non-AD forms and TBIs of different severity. These associations were, however, markedly attenuated after multivariate adjustment.

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  • Authors

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    Source

    Annals of neurology 75:3 2014 Mar pg 374-81

    MeSH

    Age of Onset
    Brain Injuries
    Cohort Studies
    Dementia
    Disease Susceptibility
    Humans
    Male
    Risk
    Sweden

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    24812697

    Citation

    Nordström, Peter, et al. "Traumatic Brain Injury and Young Onset Dementia: a Nationwide Cohort Study." Annals of Neurology, vol. 75, no. 3, 2014, pp. 374-81.
    Nordström P, Michaëlsson K, Gustafson Y, et al. Traumatic brain injury and young onset dementia: a nationwide cohort study. Ann Neurol. 2014;75(3):374-81.
    Nordström, P., Michaëlsson, K., Gustafson, Y., & Nordström, A. (2014). Traumatic brain injury and young onset dementia: a nationwide cohort study. Annals of Neurology, 75(3), pp. 374-81.
    Nordström P, et al. Traumatic Brain Injury and Young Onset Dementia: a Nationwide Cohort Study. Ann Neurol. 2014;75(3):374-81. PubMed PMID: 24812697.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Traumatic brain injury and young onset dementia: a nationwide cohort study. AU - Nordström,Peter, AU - Michaëlsson,Karl, AU - Gustafson,Yngve, AU - Nordström,Anna, PY - 2014/5/10/entrez PY - 2014/5/10/pubmed PY - 2014/6/21/medline SP - 374 EP - 81 JF - Annals of neurology JO - Ann. Neurol. VL - 75 IS - 3 N2 - OBJECTIVE: To investigate the association between traumatic brain injuries (TBIs) and the risk of young onset dementia (YOD), that is, dementia before 65 years of age. METHODS: The study cohort comprised 811,622 Swedish men (mean age 5 18 years) conscripted for military service between 1969 and 1986. TBIs, dementia, and covariates were extracted from national registers. Time-dependent exposures using Cox proportional hazard regression models were evaluated. RESULTS: During a median follow-up period of 33 years, there were 45,249 men with at least 1 TBI in the cohort. After adjustment for covariates, 1 mild TBI (hazard ratio [HR] 5 1.0, 95% confidence interval [CI] 5 0.5–2.0), at least 2 mild TBIs (HR 5 2.5, 95% CI 5 0.8–8.1), or 1 severe TBI (HR 5 0.7, 95% CI 5 0.1–5.2) were not associated with Alzheimer dementia (AD). Other types of dementia were strongly associated with the risk of 1 mild TBI (HR 5 3.8, 95% CI 5 2.8–5.2), at least 2 mild TBIs (HR 5 10.4, 95% CI 5 6.3–17.2), and 1 severe TBI (HR 5 11.4, 95% CI 5 7.4–17.5) in age-adjusted analysis. However, these associations were largely attenuated after adjustment for covariates (1 mild TBI: HR 5 1.7; at least 2 mild TBIs: HR 5 1.7; 1 severe TBI: HR 5 2.6; p < 0.05 for all). INTERPRETATION: In the present study, we found strong associations between YOD of non-AD forms and TBIs of different severity. These associations were, however, markedly attenuated after multivariate adjustment. SN - 1531-8249 UR - https://www.unboundmedicine.com/medline/citation/24812697/Traumatic_brain_injury_and_young_onset_dementia:_a_nationwide_cohort_study_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&amp;PAGE=linkout&amp;SEARCH=24812697.ui DB - PRIME DP - Unbound Medicine ER -