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Prior autopsy studies show inconsistent results, constrained by limited TBI ascertainment, semi-quantitative neuropathology methods, and selection bias.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      To examine whether TBI with loss of consciousness (TBI-LOC) is associated with quantitative measures of tau and amyloid-\u03b2\n                      <jats:sub>42<\/jats:sub>\n                      (A\u03b2\n                      <jats:sub>42<\/jats:sub>\n                      ) pathology in a community-based autopsy cohort.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The analytic sample included 810 Adult Changes in Thought study brain donors with baseline TBI-LOC ascertainment and quantitative neuropathology data, weighted to represent the full living cohort (n\u2009=\u20095763). Modified Poisson regression estimated rate ratios (RRs) and 95% confidence intervals (CIs) for associations of TBI-LOC with percent-positive AT8 tau immunoreactivity and soluble A\u03b2\n                      <jats:sub>42<\/jats:sub>\n                      (GuHCl and RIPA fractions) across brain regions. Models were adjusted for age at death, sex, education, and enrollment cohort; sensitivity analyses included unweighted and quantile models.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Weighted models showed lower frontal tau (RR\u2009=\u20090.50, p\u2009=\u20090.047) and lower soluble A\u03b2\n                      <jats:sub>42<\/jats:sub>\n                      in temporal and occipital cortices (p\u2009=\u20090.019\u20130.037) among donors with baseline TBI-LOC. In unweighted sensitivity analyses, lower temporal RIPA A\u03b2\n                      <jats:sub>42<\/jats:sub>\n                      remained significant (p\u2009&lt;\u20090.001), and select inverse associations were observed in duration-stratified analyses, particularly in small &gt;1\u2005h LOC subgroups. Quantile analyses of pathology burden similarly suggest reduced parietal A\u03b2\n                      <jats:sub>42<\/jats:sub>\n                      (p\u2009=\u20090.02\u20130.04); effects were small and driven by sparse subgroups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>TBI-LOC was not associated with greater tau or amyloid burden, and inverse associations likely reflect data sparsity rather than biological protection. These findings suggest that links between TBI and late-life cognitive decline may involve non-AD pathological processes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13872877261457138","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T12:46:02Z","timestamp":1781613962000},"page":"1194-1205","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Traumatic brain injury and late-life Alzheimer's disease neuropathology: Quantitative investigation in the Adult Changes in Thought study"],"prefix":"10.1177","volume":"112","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5350-4566","authenticated-orcid":false,"given":"Enna","family":"Selmanovic","sequence":"first","affiliation":[{"name":"Icahn School of Medicine at Mount Sinai"},{"name":"Icahn School of Medicine at Mount Sinai"},{"name":"Icahn School of Medicine at Mount Sinai"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5054-2543","authenticated-orcid":false,"given":"Laura E.","family":"Gibbons","sequence":"additional","affiliation":[{"name":"University of Washington School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3858-7949","authenticated-orcid":false,"given":"Rebecca D.","family":"Folkerth","sequence":"additional","affiliation":[{"name":"Icahn School of Medicine at Mount Sinai"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. Dirk","family":"Keene","sequence":"additional","affiliation":[{"name":"University of Washington School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amber","family":"Nolan","sequence":"additional","affiliation":[{"name":"University of Washington School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Crane","sequence":"additional","affiliation":[{"name":"University of Washington School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadia","family":"Postupna","sequence":"additional","affiliation":[{"name":"University of Washington School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilia S.","family":"Lee","sequence":"additional","affiliation":[{"name":"Washington University in St Louis"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caitlin S.","family":"Latimer","sequence":"additional","affiliation":[{"name":"University of Washington School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanelle","family":"Ariza-Torres","sequence":"additional","affiliation":[{"name":"University of Washington School of Medicine"},{"name":"Allen Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick R.","family":"Hof","sequence":"additional","affiliation":[{"name":"Icahn School of Medicine at Mount Sinai"},{"name":"Icahn School of Medicine at Mount Sinai"},{"name":"Icahn School of Medicine at Mount Sinai"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2506-0216","authenticated-orcid":false,"given":"Kristen","family":"Dams-O'Connor","sequence":"additional","affiliation":[{"name":"Icahn School of Medicine at Mount Sinai"},{"name":"Icahn School of Medicine at Mount Sinai"},{"name":"Icahn School of Medicine at Mount Sinai"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,16]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30367-6"},{"key":"e_1_3_3_3_2","volume-title":"Gulf War and Health: Volume 7: Long-Term Consequences of Traumatic Brain Injury","author":"Institute of Medicine (US) Committee on Gulf War and Health: Brain Injury in Veterans and Long-Term Health Outcomes","year":"2008","unstructured":"Institute of Medicine (US) Committee on Gulf War and Health: Brain Injury in Veterans and Long-Term Health Outcomes. 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