Educational background and previous brain injury may be associated with a higher risk of frontotemporal dementia
Summary: Previous TBI increased the risk of frontotemporal dementia in those without a genetic risk factor for FTD. In addition, the researchers found that those with FTD were less educated than those with Alzheimer’s disease.
Source: University of Eastern Finland
Two recent studies from the University of Eastern Finland show that education and previous traumatic brain injury can potentially influence the risk of frontotemporal dementia.
Frontotemporal dementia (FTD) is one of the most common causes of dementia in working-age people. FTD spectrum disorders have, depending on the subtype, major effects on behavior, linguistic functions, and cognitive processing.
Many genetic mutations have been implicated as contributors to these disorders, but their non-genetic and therefore potentially preventive risk factors remain unknown and poorly studied.
According to a recent study conducted at the University of Eastern Finland, patients with frontotemporal dementia were on average less educated than patients with Alzheimer’s disease. In addition, FTD patients who did not carry the disease-causing genetic mutation were less educated and had a higher prevalence of heart disease compared to FTD patients who did carry the mutation.
The researchers used extensive data from over 1,000 patients, including patients from Finland and Italy, with all the most common subtypes of FTD.
In addition to patients with FTD and patients with Alzheimer’s disease, the study included a control group that had not been diagnosed with any neurodegenerative disease. The results were published in Annals of Clinical and Translational Neurology.
Based on the study, patients with different subtypes of the FTD spectrum, as well as patients with genetic and non-genetic disease, appear to differ in several risk factors.
Another study shows that previous traumatic brain injury may increase the risk of FTD, especially in patients who did not carry the causative genetic mutation. In addition, patients who suffered a head injury appeared to develop FTD earlier than others, on average.
The researchers compared Finnish FTD patients with Alzheimer’s disease patients and healthy controls. The findings were published in Journal of Alzheimer’s Disease.
“These results offer a better understanding of disease mechanisms and, perhaps in the future, an opportunity to prevent frontotemporal dementia,” says PhD researcher and lead author of both articles Helmi Soppel of the University of Eastern Finland.
About this frontotemporal dementia research
Original Research: Closed access.
“Traumatic brain injury is associated with earlier onset of sporadic frontotemporal dementiaby Helmi Soppel et al. Journal of Alzheimer’s Disease
“Modifiable potential risk factors in familial and sporadic frontotemporal dementiaby Helmi Soppel et al. Annals of Clinical and Translational Neurology
Traumatic brain injury is associated with earlier onset of sporadic frontotemporal dementia
Background: There are currently few studies looking at possible modifiable risk factors for frontotemporal dementia (FTD). Objective: In this retrospective case-control study, we evaluated whether a history of traumatic brain injury (TBI) is associated with the diagnosis of FTD or modulates the clinical phenotype or age of onset in patients with FTD.
Methods: We compared the prevalence of prior TBI between individuals with FTD (N = 218) and age- and sex-matched AD patients (N = 214) or healthy controls (HC; N = 100). Based on patient records, an individual was categorized into the TBI+ group if they were reported to have suffered a lifetime TBI. Possible associations of TBI with age of onset and disease duration were also assessed in the entire group of FTD patients or separately in the sporadic and genetic FTD groups.
Results: The prevalence of previous TBI was highest in the FTD group (19.3%) compared to the AD group (13.1%, p = 0.050) or the HC group (12%, p = 0.108, not significant). Previous TBI was more often associated with sporadic cases of FTD than cases of FTD with C9orf72 repeat expansion (p = 0.003). Furthermore, a comparison of the TBI+ and TBI-FTD groups showed that previous TBI was associated with earlier age in patients with FTD (B = 3.066, p = 0.010).
conclusion: Previous TBI is particularly associated with sporadic FTD and earlier onset of symptoms. The results of this study suggest that TBI may be a trigger for neurodegenerative processes in FTD. However, further research is still needed to understand the precise underlying mechanisms.
Modifiable potential risk factors in familial and sporadic frontotemporal dementia
Only a few studies have evaluated modifiable risk factors for frontotemporal dementia (FTD). Here, we evaluated several modifiable factors and their association with phenotype, genotype, and disease prognosis in a large study population, including Finnish and Italian FTD patients and controls.
In this case-control study, we compared the presence of several cardiovascular and other lifestyle-related diseases and education between Finnish and Italian patients with familial (n= 376) and sporadically (n= 654) FTD, between different FTD phenotypes, and between a subgroup of Finnish FTD patients (n= 221) and matched Finnish patients with Alzheimer’s disease (AD) (n= 214) and cognitively healthy controls (HC) (n= 100).
Patients with sporadic FTD were less educated (p= 0.042, B = -0.560, 95% CI -1.101 to -0.019) and had more heart disease (p< 0.001, OR = 2.265, 95% CI 1.502–3.417) compared to patients with familial FTD. Finnish patients with FTD were less educated (p= 0.032, B = 0.755, 95% CI 0.064–1.466) compared to AD patients. The Finnish FTD group showed a lower prevalence of hypertension than the HC group (p= 0.003, OR = 2.162, 95% CI 1.304–3.583) and a lower prevalence of hypercholesterolemia than in the HC group (p< 0.001, OR = 2.648, 95%CI 1.548–4.531) or in the AD group (p< 0.001, OR = 1.995, 95% CI 1.333–2.986). Within the FTD group, clinical phenotypes also differed with respect to education and lifestyle factors.
Our study indicates different profiles of several modifiable factors in the FTD group depending on phenotype and family history of inheritance and that sporadic FTD in particular may be associated with modifiable risk factors.
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