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Clinical Manifestations.

Olivia Goulette1, Deling He1, Kristin E Basche1

  • 1Department of Communication Sciences and Disorders, University of Wisconsin- Madison, Madison, WI, USA.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 25, 2025
PubMed
Summary
This summary is machine-generated.

A history of traumatic brain injury (TBI) combined with early Alzheimer's disease (AD) amyloid buildup may speed up communication declines, specifically reduced letter fluency and increased speech disfluency in cognitively unimpaired individuals.

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Area of Science:

  • Neuroscience
  • Neurology
  • Cognitive Science

Background:

  • Traumatic brain injury (TBI) and Alzheimer's disease (AD) independently impair cognitive and language functions.
  • The interaction between TBI history and AD biomarkers on longitudinal cognitive and language changes remains understudied.

Purpose of the Study:

  • To investigate how TBI history interacts with AD-related predictors (amyloid, tau, APOE ε4) to affect cognitive and language trajectories in cognitively unimpaired individuals.
  • To identify early indicators of cognitive and language decline in the context of combined TBI and AD risk factors.

Main Methods:

  • Analysis of 308 cognitively unimpaired participants from the Wisconsin Registry for Alzheimer's Prevention (WRAP).
  • Assessment of amyloid and tau PET imaging, APOE ε4 status, and self-reported TBI history.
  • Linear mixed-effects models examined TBI history*age interactions on executive functioning, semantic-phonological processing, and connected speech measures, adjusting for covariates.

Main Results:

  • In amyloid-positive (A+) participants, TBI history was associated with greater average decline in letter fluency (p=0.036) and the fluency index (p=0.035), indicating increased disfluent speech.
  • No significant associations were found between TBI history and longitudinal outcomes in tau-positive or APOE ε4 carrier subgroups.

Conclusions:

  • TBI history combined with early amyloid accumulation may accelerate communication decline in cognitively unimpaired individuals.
  • Findings suggest compounded effects of TBI and AD pathology on semantic and phonological retrieval.
  • Early language changes, including reduced fluency and increased speech disfluency, may serve as potential indicators of future decline.