Traumatic brain injury in later life is associated with increased risk of dementia

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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