Head trauma and risk of dementia and Alzheimer’s disease
The Rotterdam Study
Abstract
Objective: To investigate the relation between head trauma and incidence of dementia in a prospective population-based study.
Background: Whether head trauma increases the risk of dementia and AD remains controversial. It has been suggested that the risk might be particularly increased for carriers of the APOE-ε4 allele.
Methods: The study population included 6645 participants of the prospective population-based Rotterdam Study, aged 55 years or older, who were free of dementia at baseline. Head trauma with loss of consciousness was measured at baseline by a self-report to a physician and detailed the number of head traumas, time since head trauma, and duration of loss of consciousness. The cohort was followed for incident dementia that was diagnosed according to international criteria. Logistic regression was used to calculate the risk of dementia after adjusting for age, gender, and education.
Results: No increased risk of dementia or AD was found for persons with a history of head trauma with loss of consciousness (relative risk [RR] for dementia = 1.0, 95% CI, 0.5–2.0; RR for AD = 0.8, 95% CI, 0.4–1.9). Multiple head traumas, time since head trauma, and duration of unconsciousness did not significantly influence the risk of dementia. In addition, the APOE-ε4 allele did not modify the relationship.
Conclusions: This study suggests that mild head trauma is not a major risk factor for dementia or AD in the elderly. In addition, this study does not concur with previous cross-sectional studies suggesting an interaction with the APOE genotype.
Get full access to this article
View all available purchase options and get full access to this article.
References
1.
French LR, Schuman LM, Mortimer JA, Hutton JT, Boatman RA, Christians B. A case–control study of dementia of the Alzheimer type. Am J Epidemiol 1985;121:414–421.
2.
Graves AB, White E, Koepsell TD, et al. The association between head trauma and Alzheimer’s disease. Am J Epidemiol 1990;33:491–501.
3.
Mortimer JA, van Duijn CM, Chandra V, et al. Head trauma as a risk factor for Alzheimer’s disease: a collaborative re-analysis of case-control studies. EURODEM Risk Factors Research Group. Int J Epidemiol 1991;20:S28–35.
4.
Rasmusson DX, Brandt J, Martin DB, Folstein MF. Head injury as a risk factor in Alzheimer’s disease. Brain Inj 1995;9:213–219.
5.
Salib E, Hillier V. Head injury and the risk of Alzheimer’s disease: a case control study. Int J Geriatr Psychiatry 1997;12:363–368.
6.
O’Meara ES, Kukull WA, Sheppard L, et al. Head injury and risk of Alzheimer’s disease by apolipoprotein E genotype. Am J Epidemiol 1997;146:373–384.
7.
Breteler MMB, de Groot RR, van Romunde LK, Hofman A. Risk of dementia in patients with Parkinson’s disease, epilepsy, and severe head trauma: a register-based follow-up study. Am J Epidemiol 1995;142:1300–1305.
8.
Williams DB, Annegers JK, Kokmen E, O’Brien PC, Kurland LT. Brain injury and neurologic sequelae: a cohort study of dementia, parkinsonism, and amyotrophic lateral sclerosis. Neurology 1991;41:1554–1557.
9.
Katzman R, Aronson M, Fuld P, et al. Development of dementing illnesses in an 80-year-old volunteer cohort. Ann Neurol 1989;25:317–324.
10.
Aronson MK, Ooi WL, Morgenstern H, et al. Women, myocardial infarction, and dementia in the very old. Neurology 1990;40:1102–1106.
11.
Fratiglioni L, Ahlbom A, Viitanen M, Winblad B. Risk factors for late-onset Alzheimer’s disease: a population-based, case–control study. Ann Neurol 1993;33:258–266.
12.
Li G, Shen YC, Li YT, Chen CH, Zhau YW, Silverman JM. A case–control study of Alzheimer’s disease in China. Neurology 1992;42:1481–1488.
13.
Mendez MF, Underwood KL, Zander BA, Mastri AR, Sung JH, Frey WH. Risk factors in Alzheimer’s disease: a clinicopathologic study. Neurology 1992;42:770–775.
14.
Chandra V, Kokmen E, Schoenberg BS, Beard CM. Head trauma with loss of consciousness as a risk factor for Alzheimer’s disease. Neurology 1989;39:1576–1578.
15.
Graham DI, Gentleman SM, Nicoll JAR, et al. Altered β-APP metabolism after head injury and its relationship to the aetiology of Alzheimer’s disease. Acta Neurochir 1996;66 (suppl):96–102.
16.
Smith DH, Nakamura M, McIntosh TK, et al. Brain trauma induces massive hippocampal neuron death linked to a surge in β-amyloid levels in mice overexpressing mutant amyloid precursor protein. Am J Pathol 1998;153:1005–1010.
17.
Mayeux R, Ottman R, Maestre G, et al. Synergistic effects of traumatic head injury and apolipoprotein-epsilon 4 in patients with Alzheimer’s disease. Neurology 1995;45:555–557.
18.
Katzman R, Galasko DR, Saitoh T, et al. Apolipoprotein-epsilon4 and head trauma: synergistic or additive risks? [letter]. Neurology 1996;46:889–891.
19.
Hofman A, Grobbee DE, de Jong PTVM, van den Ouweland FA. Determinants of disease and disability in the elderly. The Rotterdam Elderly Study. Eur J Epidemiol 1991;7:403–422.
20.
Ott A, Breteler MMB, van Harskamp F, et al. Prevalence of Alzheimer’s disease and vascular dementia: association with education. The Rotterdam study. BMJ 1995;310:970–973.
21.
Folstein MF, Folstein SE, McHugh PR. “Mini-mental state.” A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189–198.
22.
Copeland JR, Kelleher MJ, Kellett JM, et al. A semi-structured clinical interview for the assessment of diagnosis and mental state in the elderly: the Geriatric Mental State Schedule. I. Development and reliability. Psychol Med 1976;6:439–449.
23.
Roth M, Tym E, Mountjoy CQ, et al. CAMDEX. A standardised instrument for the diagnosis of mental disorder in the elderly with special reference to the early detection of dementia. Br J Psychiatry 1986;149:698–709.
24.
Ott A, Breteler MMB, Stijnen T, van Harskamp F, Hofman A. Incidence and risk of dementia. The Rotterdam Study. Am J Epidemiol 1998;147:574–580.
25.
American Psychiatric Association.Diagnostic and statistical manual of mental disorders. 3rd ed.Washington, DC. American Psychiatric Association, 1987.
26.
McKhann G, Drachman D, Folstein M, et al. Clinical diagnosis of Alzheimer’s disease: Report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s Disease. Neurology 1984;34:939–944.
27.
Roman GC, Tatemichi TK, Erkinjuntti T, et al. Vascular dementia: diagnostic criteria for research studies. Report of the NINDS-AIREN International Workshop. Neurology 1993;43:250–260.
28.
Wenham PR, Price WH, Blandell G. Apolipoprotein E genotyping by one-stage PCR [letter]. Lancet 1991;337:1158–1159.
29.
Schofield PW, Tang M, Marder K, et al. Alzheimer’s disease after remote head injury: an incidence study. J Neurol Neurosurg Psychiatry 1997;62:119–124.
30.
Chandra V, Philipose V, Bell PA, Lazaroff A, Schoenberg BS. Case–control study of late onset “probable Alzheimer’s disease.” Neurology 1987;37:1295–1300.
31.
Amaducci LA, Fratiglioni L, Rocca WA, et al. Risk factors for clinically diagnosed Alzheimer’s disease: a case–control study of an Italian population. Neurology 1986;36:922–931.
32.
Nemetz PN, Leibson C, Naessens JM, et al. Traumatic brain injury and time to onset of Alzheimer’s disease: a population-based study. Am J Epidemiol 1999;149:32–40.
Information & Authors
Information
Published In
Copyright
© 1999.
Publication History
Received: January 20, 1999
Accepted: July 28, 1999
Published online: December 1, 1999
Published in print: December 1, 1999
Authors
Metrics & Citations
Metrics
Citations
Download Citations
If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Select your manager software from the list below and click Download.
Cited By
- Blood Markers in Relation to a History of Traumatic Brain Injury Across Stages of Cognitive Impairment in a Diverse Cohort, Journal of Alzheimer's Disease, 97, 1, (345-358), (2024).https://doi.org/10.3233/JAD-231027
- Changes in Brain Structure and Function in a Multisport Cohort of Retired Female and Male Athletes, Many Years after Suffering a Concussion: Implications for Neuroplasticity and Neurodegenerative Disease Pathogenesis, Journal of Alzheimer's Disease Reports, 8, 1, (501-516), (2024).https://doi.org/10.3233/ADR-240021
- Single Versus Repetitive Traumatic Brain Injury: Current Knowledge on the Chronic Outcomes, Neuropathology and the Role of TDP-43 Proteinopathy, Experimental Neurobiology, 32, 4, (195-215), (2023).https://doi.org/10.5607/en23008
- How Traumatic Brain Injury History Relates to Brain Health MRI Markers and Dementia Risk: Findings from the 3C Dijon Cohort, Journal of Alzheimer's Disease, 92, 1, (183-193), (2023).https://doi.org/10.3233/JAD-220658
- Memory loss, Neurology Clinical Practice, 6, 6, (523-529), (2023)./doi/10.1212/CPJ.0000000000000314
- Investigating the mechanism of learning, memory formation and defects in humans, International Conference on Modern Medicine and Global Health (ICMMGH 2023), (52), (2023).https://doi.org/10.1117/12.2692348
- Systematic Review, Meta-Analysis, and Population Attributable Risk of Dementia Associated with Traumatic Brain Injury in Civilians and Veterans, Journal of Neurotrauma, 40, 7-8, (620-634), (2023).https://doi.org/10.1089/neu.2022.0041
- Is dementia more likely following traumatic brain injury? A systematic review, Journal of Neurology, 270, 6, (3022-3051), (2023).https://doi.org/10.1007/s00415-023-11614-4
- Alzheimer-Compound Identification Based on Data Fusion and forgeNet_SVM, Frontiers in Aging Neuroscience, 14, (2022).https://doi.org/10.3389/fnagi.2022.931729
- The Emergence of Model Systems to Investigate the Link Between Traumatic Brain Injury and Alzheimer’s Disease, Frontiers in Aging Neuroscience, 13, (2022).https://doi.org/10.3389/fnagi.2021.813544
- See more
Loading...
View Options
Get Access
Login options
Check if you have access through your login credentials or your institution to get full access on this article.
Personal login Institutional LoginPurchase Options
The neurology.org payment platform is currently offline. Our technical team is working as quickly as possible to restore service.
If you need immediate support or to place an order, please call or email customer service:
- 1-800-638-3030 for U.S. customers - 8:30 - 7 pm ET (M-F)
- 1-301-223-2300 for customers outside the U.S. - 8:30 - 7 pm ET (M-F)
- [email protected]
We appreciate your patience during this time and apologize for any inconvenience.