INS NYC 2024 Program

Poster	Poster Session 06 Program Schedule 02/15/2024 04:00 pm - 05:15 pm Room: Shubert Complex (Posters 1-60) Poster Session 06: Aging \| MCI \| Neurodegenerative Disease - PART 2 Final Abstract #57 The Impact of Traumatic Brain Injury History on Longitudinal Functional Decline in Older Individuals With and Without Mild Cognitive Impairment: A Case-Control Study Niyenth Iyengar, UT Southwestern, Dallas, United States Jeff Schaffert, UT Southwestern, Dallas, United States Christian LoBue, UT Southwestern, Dallas, United States Matthew Peters, Johns Hopkins Medicine, Baltimore, United States Hsueh-Sheng Chiang, UT Southwestern, Dallas, United States John Hart, UT Dallas, Richardson, United States Munro Cullum, UT Southwestern, Dallas, United States Category: Dementia (Non-AD) Keyword 1: traumatic brain injury Keyword 2: mild cognitive impairment Keyword 3: activities of daily living Objective: Research suggests an increased risk of later-in-life neurodegenerative conditions and/or functional decline following traumatic brain injury (TBI), especially with more severe injuries or older age at injury. This study evaluated whether TBI history and relevant injury characteristics were associated with changes in functional decline in those with normal cognition and mild cognitive impairment (MCI). Participants and Methods: Data were obtained from the National Alzheimer’s Coordinating Center (NACC) dataset. Participants were cognitively normal (n= 3,045, 70%) or had MCI (n= 1,298, 30%), and had data for at least 3 to 5 visits (M = 3.986 years). They were 68.7 years old (mean), 79.9% white, 51.1% male, 9.1% Hispanic, and had 16.3 years of education (mean). Functional abilities were assessed through the Functional Activities Questionnaire (FAQ), a 30-point informant-based measure where higher scores signify greater functional problems. Statistical analysis consisted of variable-intercept mixed linear models evaluating longitudinal FAQ scores in those with any history of TBI (yes/no), varying by TBI type (no TBI, single TBI without loss of consciousness [LOC], single TBI w/LOC, multiple TBI without LOC, and multiple TBI w/LOC), TBI recency (≤5 years ago, 6-15 years ago, or ≥15 years ago), or age of most recent TBI (≤18 years old, 19-40 years old, 41-64 years old, or ≥65 years old). Models covaried for demographics, initial diagnosis, and apolipoprotein-E4 status. Post-hoc analyses stratified groups by diagnosis (normal cognition vs. MCI), and P-value significance was set at <.01 to reduce type-I error. Results: Change in FAQ scores over time did not significantly differ by TBI history (F= 1.473, p= .208), TBI type (F= 1.386, p= .138), injury recency (F= 0.981, p= .184), or age of injury (F= 1.305, p= .184).In those with normal cognition, FAQ scores did not differ longitudinally between groups based on history of TBI (F= 0.610, p= .655), TBI type (F= 0.766, p= .686), TBI recency (F= 0.317, p= .987), or age of injury (F= 0.538, p= .938). In those with MCI, longitudinal FAQ trajectory also did not differ by TBI history (F= 1.759, p= .135), TBI type (F= 1.690, p= .044), TBI recency (F= 0.997, p= .450), or age of TBI (F= 0.920, p= .546). Conclusions: History of TBI, regardless of injury type, recency, or age, was not associated with accelerated functional decline in those with normal cognition or MCI. Findings parallel a recent longitudinal study that did not find history of TBI to be associated with accelerated neuropsychological decline in those with normal cognition, MCI, or dementia (Schaffert et al., 2022). While TBI, especially moderate to severe injuries, is an established risk factor for dementia, these data do not suggest a hastened course of decline in this well-established national cohort. However, NACC TBI data are limited in aspects of injury severity (i.e., length of LOC, post-traumatic amnesia, cerebral hemorrhaging etc.), and findings could differ if these data were available. Additional study is needed in longitudinal cohorts with well-characterized TBI histories to determine specific factors that may alter risk of long-term functional decline and/or dementia.

Poster

02/15/2024
04:00 pm - 05:15 pm
Room: Shubert Complex (Posters 1-60)

Poster Session 06: Aging | MCI | Neurodegenerative Disease - PART 2

Final Abstract #57

The Impact of Traumatic Brain Injury History on Longitudinal Functional Decline in Older Individuals With and Without Mild Cognitive Impairment: A Case-Control Study

Niyenth Iyengar, UT Southwestern, Dallas, United States
Jeff Schaffert, UT Southwestern, Dallas, United States
Christian LoBue, UT Southwestern, Dallas, United States
Matthew Peters, Johns Hopkins Medicine, Baltimore, United States
Hsueh-Sheng Chiang, UT Southwestern, Dallas, United States
John Hart, UT Dallas, Richardson, United States
Munro Cullum, UT Southwestern, Dallas, United States

Category: Dementia (Non-AD)

Keyword 1: traumatic brain injury
Keyword 2: mild cognitive impairment
Keyword 3: activities of daily living

Objective:

Research suggests an increased risk of later-in-life neurodegenerative conditions and/or functional decline following traumatic brain injury (TBI), especially with more severe injuries or older age at injury. This study evaluated whether TBI history and relevant injury characteristics were associated with changes in functional decline in those with normal cognition and mild cognitive impairment (MCI).

Participants and Methods:

Data were obtained from the National Alzheimer’s Coordinating Center (NACC) dataset. Participants were cognitively normal (n= 3,045, 70%) or had MCI (n= 1,298, 30%), and had data for at least 3 to 5 visits (M = 3.986 years). They were 68.7 years old (mean), 79.9% white, 51.1% male, 9.1% Hispanic, and had 16.3 years of education (mean). Functional abilities were assessed through the Functional Activities Questionnaire (FAQ), a 30-point informant-based measure where higher scores signify greater functional problems. Statistical analysis consisted of variable-intercept mixed linear models evaluating longitudinal FAQ scores in those with any history of TBI (yes/no), varying by TBI type (no TBI, single TBI without loss of consciousness [LOC], single TBI w/LOC, multiple TBI without LOC, and multiple TBI w/LOC), TBI recency (≤5 years ago, 6-15 years ago, or ≥15 years ago), or age of most recent TBI (≤18 years old, 19-40 years old, 41-64 years old, or ≥65 years old). Models covaried for demographics, initial diagnosis, and apolipoprotein-E4 status. Post-hoc analyses stratified groups by diagnosis (normal cognition vs. MCI), and P-value significance was set at <.01 to reduce type-I error.

Results:

Change in FAQ scores over time did not significantly differ by TBI history (F= 1.473, p= .208), TBI type (F= 1.386, p= .138), injury recency (F= 0.981, p= .184), or age of injury (F= 1.305, p= .184).In those with normal cognition, FAQ scores did not differ longitudinally between groups based on history of TBI (F= 0.610, p= .655), TBI type (F= 0.766, p= .686), TBI recency (F= 0.317, p= .987), or age of injury (F= 0.538, p= .938). In those with MCI, longitudinal FAQ trajectory also did not differ by TBI history (F= 1.759, p= .135), TBI type (F= 1.690, p= .044), TBI recency (F= 0.997, p= .450), or age of TBI (F= 0.920, p= .546).

Conclusions:

History of TBI, regardless of injury type, recency, or age, was not associated with accelerated functional decline in those with normal cognition or MCI. Findings parallel a recent longitudinal study that did not find history of TBI to be associated with accelerated neuropsychological decline in those with normal cognition, MCI, or dementia (Schaffert et al., 2022). While TBI, especially moderate to severe injuries, is an established risk factor for dementia, these data do not suggest a hastened course of decline in this well-established national cohort. However, NACC TBI data are limited in aspects of injury severity (i.e., length of LOC, post-traumatic amnesia, cerebral hemorrhaging etc.), and findings could differ if these data were available. Additional study is needed in longitudinal cohorts with well-characterized TBI histories to determine specific factors that may alter risk of long-term functional decline and/or dementia.