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Head Trauma as a Risk Factor for Alzheimer's Disease: A Collaborative Re-Analysis of Case-Control Studies
Open accessAbstract
A re-analysis of the data from 11 case-control studies was performed to investigate the association between head trauma and Alzheimer's disease (AD). To increase comparability of studies, exposures were limited to head trauma with loss of consciousness (hereafter referred to as 'head trauma') and comparisons were restricted to community (versus hospital) controls. Test for heterogeneity across studies was negative; consequently, data were pooled in subsequent analyses. The pooled relative risk for head trauma was 1.82 (95% confidence interval: 1.26-2.67). Stratified analyses showed stronger associations in cases without a positive family history of dementia and in males (versus females). Adjustment of the pooled relative risk for family history of dementia, education and alcohol consumption did not alter significantly the association between head trauma and AD. There was no interaction effect between head trauma and family history of dementia, suggesting that these risk factors operate independently. Mean age of onset was not significantly different in cases with a history of head trauma compared to cases without such a history. The findings of the pooled analysis support an association between reported head trauma and AD.
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“In particular, repeated mTBI (rmTBI) has been identified as a major risk factor for neurodegenerative diseases including Alzheimer’s disease (AD) [100], Parkinson’s disease (PD) [68] amyotrophic lateral sclerosis (ALS) [21, 2], fronto-temporal dementia (FTD) [126, 124], and chronic traumatic encephalopathy (CTE) [95].”
From Early onset senescence and cognitive impairment in a murine model of repeated mTBI (2021) · cites this paper as [100]
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Lu, K. P., Kondo, A., Albayram, Ö., Herbert, M. K., Liu, H., & Zhou, X. Z. (2016) · JAMA Neurology · doi:10.1001/jamaneurol.2016.2027 · Cited by 74
Iannucci, J., Renehan, W. E., & Grammas, P. (2020) · Frontiers in Neuroscience · doi:10.3389/fnins.2020.00762 · Cited by 75
“TBI, a condition in which neurons are exposed to high thrombin levels, is associated with an increased incidence of AD (Mortimer et al., 1991; Nemetz et al., 1999).”
BackgroundAnaesthesia in Elderly Patients with Neurodegenerative Disorders
Burton, D. A., Nicholson, G., & Hall, G. (2004) · Drugs & Aging · doi:10.2165/00002512-200421040-00002 · Cited by 71
Maxwell, W., Pennington, K., MacKinnon, M., Smith, D. H., McIntosh, T., Wilson, J. T. L., & Graham, D. (2004) · Brain : a journal of neurology · doi:10.1093/brain/awh294 · Cited by 83
“…clinical studies suggest that TBI may accelerate or exacerbate cognitive decline associated with normal ageing (Stuss et al., 1989) and induce Alzheimer’s disease-like neurodegeneration (Mortimer et al., 1991; Gentleman et al., 1993; Mayeux et al., 1993; Nicoll et al., 1995; Geddes et al., 1996).”
BackgroundNew Perspectives on Amyloid-β Dynamics After Acute Brain Injury
Magnoni, S., & Brody, D. L. (2010) · Archives of Neurology · doi:10.1001/archneurol.2010.214 · Cited by 74
Traumatic brain injury in women across lifespan
Blaya, M. O., Raval, A. P., & Bramlett, H. M. (2022) · Neurobiology of Disease · doi:10.1016/j.nbd.2022.105613 · Cited by 69
Traumatic Brain Injury and Risk of Alzheimer’s Disease and Related Dementias in the Population
Mielke, M. M., Ransom, J. E., Mandrekar, J. N., Turcano, P., Savica, R., & Brown, A. W. (2022) · Journal of Alzheimer s Disease · doi:10.3233/jad-220159 · Cited by 76
Knutsen, A. K., Magrath, E., McEntee, J., et al. (2014) · Journal of Biomechanics · doi:10.1016/j.jbiomech.2014.09.010 · Cited by 70
“The effects of brain trauma may lead to neurodegenerative diseases— for example, TBI is an established risk factor for Alzheimer’s disease, especially in combination with the ε4 allele of apolipoprotein E (Mayeux et al., 1993; Mortimer et al., 1991).”
BackgroundAssociation of traumatic brain injury and Alzheimer disease onset: A systematic review
Julien, J., Joubert, S., Ferland, M. C., Frenette, L. C., Boudreau-Duhaime, M.-M., Malo-Véronneau, L., & de Guise, É. (2017) · Annals of Physical and Rehabilitation Medicine · doi:10.1016/j.rehab.2017.03.009 · Cited by 70
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“Moreover, head trauma is one ofthe possible causes of Alzheimer's disease (Mortimer et al., 1991; Gentleman et al., 1993), in which there are decreases in cortical and hippocampal cholinergic transmission (Vogels et al., 1990; Whitehouse et al., 1982).”
d’Abramo, C., D'adamio, L., & Giliberto, L. (2020) · Journal of Personalized Medicine · doi:10.3390/jpm10030116 · Cited by 71
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Self-citationInvolvement of free oxygen radicals in β-amyloidosis: An hypothesis
Friedlich, A. L., & Butcher, L. L. (1994) · Neurobiology of Aging · doi:10.1016/0197-4580(94)90076-0 · Cited by 67
Metadata
- Authors
- Mortimer, J. A., Van Duijn, C. M., Chandra, V, Fratiglioni, L., Graves, A. B., Heyman, A., Jorm, A. F., Kokmen, E., Kondo, K., Rocca, W. A., Shalat, S. L., Soininen, H., & A Hofman for the Eurodem Risk Factors Research Group
- Affiliations
- Minneapolis VA Medical Center (US)
- Erasmus University Rotterdam (NL)
- Corresponding author
- Mortimer, J A
- Venue
- International Journal of Epidemiology
- Publisher
- Oxford University Press (OUP)
- Published
- 1991-01-01
- Volume
- 20
- Issue
- Supplement 2
- Pages
- S28-S35
- ISSN
- 0300-5771 (ISSN-L)
- 1464-3685
- OpenAlex
- W2142046013
- Cited by
- 594
- References
- 0
- Citations by year
- 2026: 4 · 2025: 9 · 2024: 10 · 2023: 16 · 2022: 28 · 2021: 23 · 2020: 21 · 2019: 35 · 2018: 16 · 2017: 28 · 2016: 37 · 2015: 31 · 2014: 22 · 2013: 11 · 2012: 21
- FWCI
- 12.29
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- other-oa
- Locations
- International Journal of Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- RePub (Erasmus University Rotterdam) (submittedVersion, other-oa)
- RePub (Erasmus University Rotterdam) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury Research
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Alzheimer's disease research and treatments
- Keywords
- head trauma, Alzheimer's disease, risk factors, loss of consciousness, family history of dementia, sex differences, age of onset, pooled relative risk, case-control study
- MeSH terms
- Alzheimer Disease, Australia, Europe, Female, Craniocerebral Trauma, Humans, Male, Risk, Risk Factors, United States, Meta-Analysis as Topic, Case-Control Studies
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