在社区居住的老年人中,创伤性脑损伤和30年来的认知变化
Andrea L C Schneider1,2, James R Pike3, Holly Elser1
1Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
概括
重复创伤性脑损伤 (TBI) 显著加快了老年人的长期认知衰退,与没有TBI的人相比,衰退的速度翻了一番. 这种效应在具有APOE ε4等位基因的个体中更为明显.
科学领域:
- 神经科学是一个神经科学.
- 老年学是一门学科.
- 流行病学 流行病学
背景情况:
- 在老年人群中,创伤性脑损伤 (TBI) 后的长期认知衰退率存在有限的证据.
- 了解TBI对认知衰老的影响对于公共卫生和临床干预至关重要.
研究的目的:
- 研究创伤性脑损伤 (TBI) 与老年人长期认知能力下降的速度之间的关联.
- 量化单个与多个TBI对30年认知轨迹的影响.
主要方法:
- 使用社区动脉样硬化风险研究 (ARIC) 的前性队列研究设计.
- 创伤性脑损伤 (TBI) 通过自我报告和ICD代码在30年的随访期间确定.
- 全球认知在五次访问中进行评估,使用调整的线性混合效应模型进行分析.
主要成果:
- 在11,701名参与者中,18%的人经历了TBI. 与没有TBI (β = -0.057) 的人相比,患有两种或多种TBI的个体的认知衰退速度是TBI的两倍多 (β = -0.158).
- 与没有TBI相比,单次TBI (β = -0.052) 患者的认知衰退没有显著差异.
- 患有≥2TBIs的个体的加速衰退相当于研究期间的9.7年衰老,在APOE ε4载体中更为明显.
结论:
- 创伤性脑损伤 (TBI) 在老年人中显著改变认知衰退轨迹.
- 多重TBI带来了加速认知衰老的重大风险,突出了TBI预防和管理在这个人口群体中的重要性.
- 与APOE ε4的相互作用表明,对TBI的认知影响存在潜在的遗传敏感性.
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