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 - 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 -