TY - JOUR
T1 - Traumatic Brain Injury and Early Onset Dementia in Post 9-11 Veterans
AU - Kennedy, Eamonn
AU - Panahi, Samin
AU - Stewart, Ian J.
AU - Tate, David F.
AU - Wilde, Elisabeth A.
AU - Kenney, Kimbra
AU - Werner, J. Kent
AU - Gill, Jessica
AU - Diaz-Arrastia, Ramon
AU - Amuan, Megan
AU - Van Cott, Anne C.
AU - Pugh, Mary Jo
N1 - Funding Information:
This work was supported by the Assistant Secretary of Defense for Health Affairs endorsed by the Department of Defense, through the Psychological Health/Traumatic Brain Injury Research Program Long-Term Impact of Military-Relevant Brain Injury Consortium (LIMBIC) Award/W81XWH-18-PH/TBIRP-LIMBIC under Awards No. W81XWH1920067 and W81XWH-13-2-0095, and by the U.S. Department of Veterans Affairs Awards No. I01 CX002097, I01 CX002096, I01 HX003155, I01 RX003444, I01 RX003443, I01 RX003442, I01 CX001135, I01 CX001246, I01 RX001774, I01 RX 001135, I01 RX 002076, I01 RX 001880, I01 RX 002172, I01 RX 002173, I01 RX 002171, I01 RX 002174, and I01 RX 002170. The U.S. Army Medical Research Acquisition Activity, 839 Chandler Street, Fort Detrick MD 21702-5014 is the awarding and administering acquisition office. Dr. Pugh was also supported by VA Health Services Research and Development Service Research Career Scientist Award, 1 IK6 HX002608.
Publisher Copyright:
© 2022 Taylor & Francis Group, LLC.
PY - 2022
Y1 - 2022
N2 - Objectives: To assess traumatic brain injury (TBI)-related risks factors for early-onset dementia (EOD). Background: Younger Post-9/11 Veterans may be at elevated risk for EOD due to high rates of TBI in early/mid adulthood. Few studies have explored the longitudinal relationship between traumatic brain injury (TBI) and the emergence of EOD subtypes. Methods: This matched case-control study used data from the Veterans Health Administration (VHA) to identify Veterans with EOD. To address the low positive predictive value (PPV = 0.27) of dementia algorithms in VHA records, primary outcomes were Alzheimer’s disease (AD) and frontotemporal dementia (FTD). Logistic regression identified conditions associated with dementia subtypes. Results: The EOD cohort included Veterans with AD (n = 689) and FTD (n = 284). There were no significant demographic differences between the EOD cohort and their matched controls. After adjustment, EOD was significantly associated with history of TBI (OR: 3.05, 2.42–3.83), epilepsy (OR: 4.8, 3.3–6.97), other neurological conditions (OR: 2.0, 1.35–2.97), depression (OR: 1.35, 1.12–1.63) and cardiac disease (OR: 1.36, 1.1–1.67). Conclusion: Post-9/11 Veterans have higher odds of EOD following TBI. A sensitivity analysis across TBI severity confirmed this trend, indicating that the odds for both AD and FTD increased after more severe TBIs.
AB - Objectives: To assess traumatic brain injury (TBI)-related risks factors for early-onset dementia (EOD). Background: Younger Post-9/11 Veterans may be at elevated risk for EOD due to high rates of TBI in early/mid adulthood. Few studies have explored the longitudinal relationship between traumatic brain injury (TBI) and the emergence of EOD subtypes. Methods: This matched case-control study used data from the Veterans Health Administration (VHA) to identify Veterans with EOD. To address the low positive predictive value (PPV = 0.27) of dementia algorithms in VHA records, primary outcomes were Alzheimer’s disease (AD) and frontotemporal dementia (FTD). Logistic regression identified conditions associated with dementia subtypes. Results: The EOD cohort included Veterans with AD (n = 689) and FTD (n = 284). There were no significant demographic differences between the EOD cohort and their matched controls. After adjustment, EOD was significantly associated with history of TBI (OR: 3.05, 2.42–3.83), epilepsy (OR: 4.8, 3.3–6.97), other neurological conditions (OR: 2.0, 1.35–2.97), depression (OR: 1.35, 1.12–1.63) and cardiac disease (OR: 1.36, 1.1–1.67). Conclusion: Post-9/11 Veterans have higher odds of EOD following TBI. A sensitivity analysis across TBI severity confirmed this trend, indicating that the odds for both AD and FTD increased after more severe TBIs.
KW - TBI severity
KW - Traumatic brain injury
KW - early onset dementia
KW - matched case-control
UR - http://www.scopus.com/inward/record.url?scp=85124364960&partnerID=8YFLogxK
U2 - 10.1080/02699052.2022.2033846
DO - 10.1080/02699052.2022.2033846
M3 - Article
C2 - 35125061
AN - SCOPUS:85124364960
SN - 0269-9052
VL - 36
SP - 620
EP - 627
JO - Brain Injury
JF - Brain Injury
IS - 5
ER -