Rate of incident dementia and care needs among older adults with new traumatic brain injury: a population-based cohort study

1. In this cohort of older adults, traumatic brain injury (TBI) in later life was associated with an increased incidence of dementia.

Evidence Rating Level: 2 (Good) 

Traumatic brain injuries (TBI) have become increasingly common in the elderly population in Canada, particularly those resulting from falls. TBIs are diagnosed when a patient presents after a direct head injury along with either loss of consciousness, post-traumatic amnesia, disorientation, or neurologic deficits. TBI in older adults is associated with increased costs and a greater burden on the healthcare system. Older adults who experienced a TBI often experience unique challenges, such as cognitive decline, increasing their need for care. While TBI is a known risk factor for dementia in middle-aged individuals, its impact on those over 65 remains understudied. To address the gaps, this retrospective study aimed to assess the association between late-life TBI and dementia risk and care needs, and to identify social determinants of health that contribute to poorer outcomes. 132,113 individuals (mean age of TBI age group, 77.2, SD [7.7]). Individuals with a new TBI had a greater rate of developing dementia compared to those without. There was a higher incidence of dementia in those with TBI in the first 5 years (HR 1.69, 95% CI, 1.66 to 1.72), and after 5 years (HR 1.56, 95% CI 1.53 to 1.59). Late-life TBI was associated with an increased use of publicly funded home care (HR 1.30, 95% CI 1.29 to 1.31) and long-term care admission (HR 1.45, 95% CI 1.42 to 1.47). Dementia was more common in older females from low-income neighbourhoods compared to their male counterparts (29.0% vs 24.7%). Overall, the incidence of late-life TBI was associated with increased risk of developing dementia, usage of publicly funded home care, and admission to a long-term care facility. 

Click here to read this study in The Canadian Medical Association Journal

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