American Journal of Epidemiology Vol. 131, No. 3: 491-501
Copyright © 1990 by The Johns Hopkins University School of Hygiene and Public Health
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THE ASSOCIATION BETWEEN HEAD TRAUMA AND ALZHEIMER'S DISEASE
1Battelle Seattle Research Center Seattle, WA
2Department of Epidemiology, University of Washington, School of Public Health and Community Medicine Seattle, WA
3Departments of Epidemiology and Health Services, University of Washington, School of Public Health and Community Medicine Seattle, WA
4Department of Psychiatry and Behavioral Medicine, Bowman Gray School of Medicine Winston-Salem, NC
5Department of Biostatistics, University of Washington, School of Public Health and Community Medicine Seattle, WA
6Department of Medicine, University of Washington, School of Medicine Seattle, WA
7Department of Psychiatry and Behavioral Sciences, University of Washington, School of Medicine Seattle, WA
The relation between head trauma and Alzheimer's disease was one of four major risk factors explored in a case-control study of 130 matched pairs; cases were clinically diagnosed between January 1980 and June 1985 at two geriatric psychiatric clinics in Seattle, Washington, and controls were friends or nonbtood relatives of the cases. Subjects were matched by age, sex, and relationship between the case and his or her surrogate respondent Head injuries which resulted in a loss of consciousness or which caused the subject to seek medical care were documented by means of interviews with surrogate respondents. A history of head injury was recorded for 24% of the cases and 8.5% of the controls, yielding an odds ratio of 3.5 (95% confidence interval 1.5–8.3) in conditional logistic regression analysis adjusted for age at onset of disease symptoms and family history of Alzheimer's disease. The estimated risk of Alzheimer's disease increased as the time between the last head trauma event and the onset of disease symptoms diminished (p = 0.002). This trend remained statistically significant (p = 0.006) when head injuries which occurred within 5 years of onset of the disease were excluded from the analysis. There was some difference between cases and controls for the average duration of unconsciousness in events accompanied by such a loss, but this was not statistically significant The two groups were also similar in the circumstances surrounding the injuries and in the frequency of alcohol problems. This is the third case-control study to find a statistically significant association between head trauma and Alzheimer's disease.
Alzheimer's disease; head injuries
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