American Journal of Epidemiology Vol. 135, No. 7: 775-782
Copyright © 1992 by The Johns Hopkins University School of Hygiene and Public Health
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Head Trauma and the Risk of Alzheimer's Disease
1Department of Epidemiology and Btostatistics Erasmus University Medical School Rotterdam the Netherlands
2Working Group Epidemiology of Dementia Groningen the Netherlands
3Department of Neurology Academic Hospital Gronin-gen the Netherlands
Reprint requests to Cornelia M. van Duijn, Department of Epidemiology and Biostatistics, Erasmus University Medical School, P. 0. Box 1738, 3000 DR Rotterdam, the Netherlands
A population-based case-control study of the association between head trauma and Alzheimer's disease was conducted in the Netherlands from 1980 to 1987. The study comprised 198 patients with clinically diagnosed early onset Alzheimer's disease and 198 age- and sex-matched population controls. Adjusted for sex, age, family history of. dementia, and education, the odds ratio of a history of head trauma with loss of consciousness was 1.6 (95% confidence interval (Cl) 0.8–3.4). The odds ratio for men was 2.5 (95% Cl 0.9%7.0), and that for women was 0.9 (95% Cl 0.3–2.8). The increase in odds ratio was limited to head trauma that occurred within the period of 10 years prior to the onset of dementia (odds ratio = 10.0; 95% Cl 1.0–96.8). There was no evidence of effect modification by family history of dementia as measured on a multiplicative scale. However, the power to show interaction may have been low in this study. The authors' findings are compatible with the view that head trauma may be implicated in Alzheimer's disease, with a short lag time between the head trauma and the first symptoms of disease. The association needs to be confirmed in a prospective follow-up study to fully exclude the possibility of recall bias. Am J Epidemiol 1992;135:775–82.
Alzheimer's disease; case-control studies; dementia; head injuries
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