ABSTRACT
AIMS: To evaluate the relationship between self-reported head injury and cognitive impairment, dementia, mortality, and Alzheimer's disease (AD)-type pathological changes. METHODS: Clinical and neuropathological data from participants enrolled in a longitudinal study of aging and cognition (n = 649) were analyzed to assess the chronic effects of self-reported head injury. RESULTS: The effect of self-reported head injury on the clinical state depended on the age at assessment: for a 1-year increase in age, the OR for the transition to clinical mild cognitive impairment (MCI) at the next visit for participants with a history of head injury was 1.21 and 1.34 for the transition from MCI to dementia. Without respect to age, head injury increased the odds of mortality (OR = 1.54). Moreover, it increased the odds of a pathological diagnosis of AD for men (OR = 1.47) but not women (OR = 1.18). Men with a head injury had higher mean amyloid plaque counts in the neocortex and entorhinal cortex than men without. CONCLUSIONS: Self-reported head injury is associated with earlier onset, increased risk of cognitive impairment and dementia, increased risk of mortality, and AD-type pathological changes.
Subject(s)
Alzheimer Disease/epidemiology , Cognitive Dysfunction/epidemiology , Craniocerebral Trauma/epidemiology , Age Factors , Aged , Aged, 80 and over , Alzheimer Disease/pathology , Brain/pathology , Brain Concussion/epidemiology , Brain Concussion/pathology , Cognitive Dysfunction/pathology , Cohort Studies , Craniocerebral Trauma/pathology , Educational Status , Female , Humans , Linear Models , Male , Markov Chains , Middle Aged , Retrospective Studies , Risk Factors , Unconsciousness/epidemiology , Unconsciousness/pathologySubject(s)
Activities of Daily Living/classification , Alzheimer Disease/drug therapy , Cholinergic Antagonists/adverse effects , Cholinesterase Inhibitors/adverse effects , Mental Status Schedule , Aged , Alzheimer Disease/diagnosis , Cholinergic Antagonists/therapeutic use , Cholinesterase Inhibitors/therapeutic use , Disease Progression , Drug Interactions , Drug Therapy, Combination , Humans , Reproducibility of Results , Retrospective StudiesABSTRACT
OBJECTIVE: The objective of this study was to determine whether chronic use of medications with anticholinergic (AC) properties impact older adults' cognitive functioning. METHODS: Six years of cognitive test data from two groups of older adults (AC and control) were examined retrospectively (N = 592). RESULTS: Declines over time were found for the AC group on parts A and B of the Trail Making Test. CONCLUSION: Physicians prescribing ACs to older adult patients should be aware of their potential effects on psychomotor speed and executive functioning. These cognitive effects may lead to impairments in daily functioning resulting in the need to reevaluate patient medications.