Premium
[O5–07–03]: NEUROPATHOLOGY DIAGNOSES IN THE OLDEST‐OLD: RESULTS FROM A LARGE BRAZILIAN AUTOPSY STUDY
Author(s) -
Suemoto Claudia K.,
Paraizo Leite Renata Elaine,
Lucena FerrettiRebustini Renata Eloah,
Diehl Rodriguez Roberta,
Farfel Jose M.,
Nitrini Ricardo,
Pasqualucci Carlos Augusto,
JacobFilho Wilson,
Grinberg Lea T.
Publication year - 2017
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2017.07.545
Subject(s) - neuropathology , medicine , dementia , hippocampal sclerosis , cerebral amyloid angiopathy , arteriolosclerosis , population , lewy body , autopsy , alzheimer's disease , pathology , disease , psychiatry , temporal lobe , environmental health , epilepsy
repetitive head impacts (RHI), including American football. Although most pathologically confirmed cases of CTE had a history of RHI, how exposure relates to neuropathology is not known. We hypothesized that as cumulative RHI exposure increased, CTE risk would correspondingly increase. Methods: In a convenience sample of 163 deceased former American football players from the Veterans Affairs-Boston University-Concussion Legacy Foundation Brain Bank, we retrospectively determined participants’ duration of play (in years), player positions, levels of play, and concussion number. We estimated each participant’s cumulative impacts using published football helmet sensor data. To circumvent errors in measuring cumulative impact, we used instrumental variable methods to evaluate this variable, assigning duration of play as the instrument. Analyses were adjusted for age at death.Results:134 of 163 participants met neuropathological diagnostic criteria for CTE. Those with CTE played an average of 7 years longer than those without CTE, with odds of diagnosis 25% higher per additional year played (OR1⁄41.25, 95% CI, 1.11-1.40). In the instrumental variable analyses, those with CTE had an average of 3,300 more head impacts with odds of diagnosis 64% higher per 1,000 additional impacts (OR1⁄41.64; 95% CI, 1.28-2.36). Concussion number was not significantly associated with CTE risk. Conclusions:The odds of having CTE at death nearly double with every 3 additional years of play. Estimated cumulative impacts, regardless of whether symptoms are present (concussion), predict CTE risk. Brain banks suffer from marked selection bias and these results should be interpreted cautiously until they can be replicated. Table 1 Characteristics of the sample by age groups (n1⁄41,092)