• Michael J C Bray, Lisa N Richey, Barry R Bryant, Akshay Krieg, Sahar Jahed, William Tobolowsky, Christian LoBue, and Matthew E Peters.
• Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
• Alzheimers Dement. 2021 Apr 1; 17 (4): 686-691.

IntroductionTraumatic brain injury (TBI) may alter the course of neuropsychiatric symptom (NPS) onset during dementia development. The connection among TBI, NPS, and dementia progression is of increasing interest to researchers and clinicians.MethodsIncidence of NPS was examined in participants with normal cognition who progressed to all-cause dementia based on whether TBI history was present (n = 130) or absent (n = 849). Survival analyses were used to examine NPS incidence across 7.6 ± 3.0 years of follow-up.ResultsParticipants with TBI history had increased prevalence and incidence of apathy (44.7% vs 29.9%, P = .0062; HRadj. = 1.708, P = .0018) and motor disturbances (17.2% vs 9.5%, P = .0458; HRadj. = 2.023, P = .0168), controlling for demographics and type of dementia diagnosis. Earlier anxiety onset was associated with TBI (692 days prior to dementia diagnosis vs 161 days, P = .0265).DiscussionHistory of TBI is associated with increased risk for and earlier onset of NPS in the trajectory of dementia development.© 2020 the Alzheimer's Association.

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