Sex-speciﬁc incident dementia in patients with central nervous system trauma

Alzheimer’s & Dementia: Diagnosis, Assessment & Disease Monitoring, 2019 · DOI: https://doi.org/10.1016/j.dadm.2019.03.003 · Published: January 1, 2019

Neurology Brain Injury

Simple Explanation

This study investigates the link between central nervous system (CNS) trauma, like traumatic brain injury (TBI) and spinal cord injury (SCI), and the later development of dementia. The study found that the severity of TBI and the presence of SCI, combined with age, can increase the risk of developing dementia. Women were found to be at higher risk than men. The researchers suggest that understanding these risks, especially considering sex differences, is important for identifying individuals who are more likely to develop dementia after experiencing CNS trauma.

Study Duration

52 months median follow-up

Participants

712,708 adult patients

Evidence Level

Not specified

Key Findings

1
Moderate and unspecified TBI severity was significantly associated with incident dementia.
2
Spinal cord injury comorbidity in TBI has an additive effect on risk.
3
The effect of severe TBI on incident dementia became apparent in younger men and women and decreased with age; it was not observable in either sex aged .80 years.

Research Summary

This study examined the relationship between CNS trauma and dementia, finding that TBI severity and SCI comorbidity interact with age to influence dementia onset, with women at greater risk. The research also identified sleep disorders as a novel risk factor for dementia onset in individuals with CNS trauma. The study highlights the importance of sex-specific risk stratification for patients with CNS trauma to better identify those at higher risk of developing dementia.

Practical Implications

Risk Stratification

Sex-specific risk stratification of patients with CNS trauma is crucial for identifying those most likely to develop dementia.

Personalized Prediction

Individualized predictions based on Cox regressions can estimate the probability of developing postinjury dementia, aiding in targeted interventions.

Targeted Interventions

Societal advances, lifestyle modifications, and quaternary preventions could reduce dementia risk in both men and women with CNS trauma.

Study Limitations

1
Unavailability of some predictors (e.g., toxic environmental exposures, family history of dementia).
2
The effect of any intervention for TBI, SCI, and other comorbidities on the development of dementia was not investigated.
3
Misclassification of patients is possible, resulting in CNS trauma–related predictors to be calculated below their true values.

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