Citation

Kaup A, Toomey R, Bangen KJ, Delano-Wood L, Yaffe KC, Panizzon MS, Lyons MJ, Franz CE, Kremen WS. J. Neurotrauma 2019; 36(2): 338-347.

Affiliation

University of California San Diego, Center for Behavior Genetics of Aging, La Jolla, California, United States ; wkremen@ucsd.edu.

Copyright

(Copyright © 2019, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2018.5695

PMID

29978738

Abstract

Traumatic brain injury (TBI), post-traumatic stress disorder (PTSD) and depressive symptoms each increase risk for cognitive impairment in older adults. We investigated whether TBI has long-term associations with cognition in late middle-aged men, and examined the role of current PTSD/depressive symptoms. Participants were 953 men (ages 56-66) from the Vietnam Era Twin Study of Aging (VETSA), who were classified by presence or absence of 1) history of TBI and 2) current elevated psychiatric symptoms (defined as PTSD or depressive symptoms above cut-offs). TBIs occurred an average of 35 years prior to assessment. Participants completed cognitive testing examining nine domains. In mixed effects models, we tested the effect of TBI on cognition including for interactions between TBI and elevated psychiatric symptoms. Models adjusted for age, premorbid cognitive ability assessed at average age 20 years, apolipoprotein E genotype, and substance abuse. 33% (n=310) of participants had TBI, mostly mild and remote. 23% (n=72) of those with TBI and 18% (n=117) without TBI had current elevated psychiatric symptoms. TBI and psychiatric symptoms had interactive effects on cognition, particularly executive functioning. Group comparison analyses showed that men with both TBI and psychiatric symptoms demonstrated deficits primarily in executive functioning. Cognition was largely unaffected in men with either risk factor in isolation. Among late middle-aged men, the combination of even mild and very remote TBI with current elevated psychiatric symptoms is associated with deficits in executive function and related abilities. Future longitudinal studies should investigate how TBI and psychiatric factors interact to impact brain aging.

Language: en

Keywords

COGNITIVE FUNCTION; NEUROPSYCHOLOGY; TRAUMATIC BRAIN INJURY