Association of Traumatic Brain Injury, Mild Cognitive Impairment and Dementia in the Framingham Heart Study’s Original Cohort (S39.009)

Abstract

<h3>Objective:</h3> To estimate the associations between traumatic brain injury (TBI), mild cognitive impairment (MCI), all-cause dementia, and Alzheimer’s disease (AD) dementia. <h3>Background:</h3> Research on the relationship between TBI, AD and AD related dementias is inconsistent. <h3>Design/Methods:</h3> The Framingham Heart Study (FHS) is a population-based cohort study which recruited its original cohort, ages 30–62, between 1948–1950. Information on TBIs was collected by self-report and comprehensive review of medical records obtained through FHS health history updates until death. TBI occurrence and severity were operationalized using modified American Congress of Rehabilitation Medicine and Veterans Affairs/Department of Defense criteria respectively. MCI, dementia, and AD dementia consensus diagnoses were operationalized using modified Peterson criteria, Diagnostic and Statistical Manual of Mental Disorders, 4^th edition, and National Institute of Neurological and Communicative Diseases and Stroke/AD and Related Disorders Association criteria respectively. <h3>Results:</h3> The study included 715 participants with TBI and 2145 age- and sex-matched participants without TBI who were cognitively normal at time of TBI and followed for an average of 16±17 years. 567 (26.43%), 461 (21.49%) and 373 (17.39%) participants without TBI developed MCI, all cause dementia and AD dementia respectively compared with 271 (37.9%), 218 (30.49%) and 131 (21.12%) of those with TBI. For mild TBI, hazard ratios (HRs) for MCI, all-cause dementia and AD dementia were 1.55 (95%CI 1.14–2.12), 1.47 (95%CI 1.02–2.14), and 1.06 (95%CI 0.68–1.66) respectively. For moderate-to-severe TBI, HRs for MCI, all cause dementia and AD dementia were 3.50 (95%CI 1.10–11.17), 4.61 (95%CI 0.96–22.14), and 6.36 (95%CI 0.72–56.50) respectively. <h3>Conclusions:</h3> In this cohort followed for more than a decade and comprehensively assessed for TBI and dementia-related outcomes, there were small to moderate sized associations of mild TBI and large associations of moderate-severe TBI with MCI and all-cause dementia. Association between mild TBI and dementia may be driven by non-AD etiologies. <b>Disclosure:</b> Dr. Durape has nothing to disclose. Dr. Joshi has nothing to disclose. Ms. Burton has nothing to disclose. Mr. Chien-Young has received research support from the National Heart, Lung, And Blood Institute of the National Institutes of Health under Award Number T35HL139444. Miss Price has nothing to disclose. Miss Shanabrook has nothing to disclose. Miss Yhang has nothing to disclose. Mrs. Liu has nothing to disclose. The institution of Dr. Ang has received research support from NIH. Dr. Devine has nothing to disclose. Dr. Gurnani has nothing to disclose. Dr. Katz has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Law firms. The institution of Dr. Katz has received research support from NINDS/NIH. Dr. Katz has received publishing royalties from a publication relating to health care. Yorghos Tripodis, 5406 has nothing to disclose. The institution of Michael Alosco, PHD has received research support from NIH. Dr. Dams-O’Connor has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Various law firms. The institution of Dr. Dams-O’Connor has received research support from NIH. The institution of Dr. Dams-O’Connor has received research support from Department of Defense. The institution of Dr. Dams-O’Connor has received research support from National Institute on Disability Independent Living and Rehabilitation Research. The institution of Dr. Dams-O’Connor has received research support from Patient Reported Outcomes Research Institute. Dr. Au has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biogen. Dr. Au has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Dr. Au has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Au has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for NovoNordisk. Dr. Au has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for GSK. Dr. Au has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Eisai. Dr. Au has received publishing royalties from a publication relating to health care. Dr. Au has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant with Davos Alzheimer’s Collaborative. Dr. Au has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant with High Lantern. The institution of Dr. Mez has received research support from NIH, DOD.