Leveraging the Framingham Study to Investigate Relationships Between Traumatic Brain Injury, Military Service, Alzheimer s Disease and Related Dementias
Abstract
Background: People who serve in the military have specific risk of exposure to head injury or traumatic brain injury (TBI) in addition to the typical risks faced by all people. TBIs can be fatal or cause severe disability, but many people survive TBI and recover well. The long-term consequences of survived TBIs are not entirely clear. Some studies suggest an association between TBI and dementia, while others do not. Both TBI and military service may increase the risk for medical problems in late life, but other studies suggest military service can have a positive impact on health. These questions are of great importance to society at large and to the Department of Defense (DoD) in particular. As medical care has improved, many people are surviving TBI and living to older adulthood, so determining the effects of survived head injuries on the aging brain becomes incredibly relevant. This information is needed to plan service needs for the numerous service members and civilians who sustain a TBI. To learn more, we will study associations of TBI and military service with Alzheimer s disease (AD), other AD-related dementias (ADRD), and long-term health. The goal of our project is to study the late life health associations of TBI and military service by using detailed data already available from a large-scale population-based longitudinal research study of veterans and civilians. We will use extensive existing resources from the Framingham Heart Study (FHS), which includes access to a long-committed volunteer study sample, as well as health, lifestyle, genetic, cognitive, brain imaging, and brain autopsy data. We will also collect new self-report TBI and military service data using methods recommended by the National Institutes of Health. This study will comprehensively characterize the role of TBI and military service on a wide array of AD/ADRD outcomes, as well as identify factors that may modify these relationships. Hypothesis: Our proposal addresses the overarching hypothesis that TBI and military service are risk factors for AD/ADRD-related clinical, brain imaging, and brain autopsy outcomes. We will explore this hypothesis through the following Specific Aims: 1. We will determine the impact of TBI and military service on clinical AD/ADRD outcomes. We will test the hypotheses that (a) TBI and military service are associated with risk for AD and Parkinson s disease (PD), and (b) TBI and military service are associated with greater late-life declines in cognition, functional activities, mood, and motor function. We will determine if (c) genetic factors associated with brain function and disease and d) demographic, clinical, and lifestyle factors impact these relationships with TBI and military service. 2. We will determine the impact of TBI and military service on AD/ADRD brain changes as measured by neuroimaging. We will test the hypotheses that TBI and military service are associated with multiple neuroimaging indices of neurodegeneration (a) cross-sectionally and (b) longitudinally over time. We will determine if (c) genetic factors associated brain function and disease and (d) demographic, clinical, and lifestyle factors impact these relationships with TBI and military service. 3. We will determine the impact of TBI and military service on neuropathological AD/ADRD outcomes. We will use autopsy data to test the hypothesis that (a) TBI and military service are associated with autopsy-confirmed diagnoses of AD and PD, and (b) TBI and military service are associated with neuropathological indices of AD/ADRD. We will determine if (c) genetic factors associated with brain function and disease, and (d) clinical factors impact these relationships with TBI and military service. Research Strategy: We will address these aims using the well-characterized multi-generational FHS cohorts, which together include nearly 11,000 individuals followed for up to 69 years. A key strength of this proposal
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Oct 29, 2018
- Source ID
- W81XWH1810580
Entities
People
- Jesse Mez
Organizations
- Boston University Medical Campus
- United States Army