scholarly journals Sex, race, and risk of dementia diagnosis after traumatic brain injury among older veterans

Neurology ◽  
2020 ◽  
Vol 95 (13) ◽  
pp. e1768-e1775 ◽  
Author(s):  
Erica Kornblith ◽  
Carrie B. Peltz ◽  
Feng Xia ◽  
Brenda Plassman ◽  
Tatjana Novakovic-Apopain ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Interaction Effect ◽  
Significant Interaction ◽  
Female Veterans ◽  
Health Administration ◽  
Dementia Diagnosis ◽  
Male And Female ◽  
Increased Risk ◽  
To Receive

ObjectiveTo investigate whether sex and race differences exist in dementia diagnosis risk associated with traumatic brain injury (TBI) among older veterans.MethodsUsing Fine-Gray regression models, we investigated incident dementia diagnosis risk with TBI exposure by sex and race.ResultsAfter the exclusion of baseline prevalent dementia, the final sample (all veterans ≥55 years of age diagnosed with TBI during the 2001–2015 study period and a random sample of all veterans receiving Veterans Health Administration care) included nearly 1 million veterans (4.3% female; 81.8% White, 11.5% Black, and 1.25% Hispanic), 96,178 with TBI and 903,462 without TBI. Compared to those without TBI, Hispanic veterans with TBI were almost 2 times more likely (17.0% vs 10.3%; hazard ratio [HR] 1.74, 95% confidence interval [CI] 1.51–2.01), Black veterans with TBI were >2 times more likely (11.2% vs 6.4%; HR 2.15, 95% CI 2.02–2.30), and White veterans with TBI were nearly 3 times more likely to receive a dementia diagnosis (12.0% vs 5.9%; HR 2.71, 95% CI 2.64–2.77). A significant interaction between TBI and race for dementia diagnosis was observed (p < 0.001). Both male and female veterans with TBI were more than twice as likely (men 11.8% vs 5.9%, HR 2.60, 95% CI 2.54–2.66; women 6.3% vs 3.1%, HR 2.36, 95% CI 2.08–2.69) to receive a diagnosis of dementia compared to those without. There was a significant interaction effect between sex and TBI (p = 0.02), but the magnitude of differences was small.ConclusionsIn this large, nationwide cohort of older veterans, all race groups with TBI had increased risk of dementia diagnosis, but there was an interaction effect such that White veterans were at greatest risk for dementia after TBI. Further research is needed to understand the mechanisms for this discrepancy. Differences in dementia diagnosis risk for men and women after TBI were significant but small, and male and female veterans had similarly high risks of dementia diagnosis after TBI.

scholarly journals Traumatic brain injury among female veterans: a review of sex differences in military neurosurgery

2018 ◽  
Vol 45 (6) ◽  
pp. E16 ◽  
Author(s):  
Lily H. Kim ◽  
Jennifer L. Quon ◽  
Felicia W. Sun ◽  
Kristen M. Wortman ◽  
Maheen M. Adamson ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Sex Differences ◽  
Brain Injury ◽  
Mortality Data ◽  
Female Veterans ◽  
Female Representation ◽  
Social Challenges ◽  
Increased Risk ◽  
The Face ◽  
The Impact

The impact of traumatic brain injury (TBI) has been demonstrated in various studies with respect to prevalence, morbidity, and mortality data. Many of the patients burdened with long-term sequelae of TBI are veterans. Although fewer in number, female veterans with TBI have been suggested to suffer from unique physical, mental, and social challenges. However, there remains a significant knowledge gap in the sex differences in TBI. Increased female representation in the military heralds an increased risk of TBI for female soldiers, and medical professionals must be prepared to address the unique health challenges in the face of changing demographics among the veteran TBI population. In this review, the authors aimed to present the current understanding of sex differences in TBI in the veteran population and suggest directions for future investigations.

scholarly journals Traumatic Brain Injury and Incidence Risk of Sleep Disorders in Nearly 200,000 US Veterans

Neurology ◽  
2021 ◽  
Vol 96 (13) ◽  
pp. e1792-e1799
Author(s):  
Yue Leng ◽  
Amy L. Byers ◽  
Deborah E. Barnes ◽  
Carrie B. Peltz ◽  
Yixia Li ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Sleep Apnea ◽  
Sleep Disorders ◽  
Movement Disorders ◽  
Time Lag ◽  
Health Administration ◽  
Increased Risk ◽  
Subsequent Risk

ObjectiveTo test the hypothesis that veterans with traumatic brain injury (TBI) have an increased subsequent risk of sleep disorders, we studied the longitudinal association between TBI and incident sleep disorders in nearly 200,000 veterans.MethodsWe performed a cohort study of all patients diagnosed with a TBI in the Veterans Health Administration system from October 1, 2001, to September 30, 2015, who were age-matched 1:1 to veterans without TBI. Veterans with prevalent sleep disorders at baseline were excluded. Development of sleep disorders was defined as any inpatient or outpatient diagnosis of sleep apnea, hypersomnia, insomnia, or sleep-related movement disorders based on ICD-9 codes after the first TBI diagnosis or the random selection date for those without TBI. We restricted the analysis to those with at least 1 year of follow-up. We used Cox proportional hazards models to examine the association between TBI and subsequent risk of sleep disorders.ResultsThe study included 98,709 veterans with TBI and 98,709 age-matched veterans without TBI (age 49 ± 20 years). After an average follow-up of 5 (1–14) years, 23,127 (19.6%) veterans developed sleep disorders. After adjustment for demographics, education, income, and medical and psychiatric conditions, those who had TBI compared to those without TBI were 41% more likely to develop any sleep disorders (hazard ratio 1.41 [95% confidence interval 1.37–1.44]), including sleep apnea (1.28 [1.24–1.32]), insomnia (1.50 [1.45–1.55]), hypersomnia (1.50 [1.39–1.61]), and sleep-related movement disorders (1.33 [1.16–1.52]). The association was stronger for mild TBIs, did not differ appreciably by presence of posttraumatic stress disorder, and remained after a 2-year time lag.ConclusionIn 197,418 veterans without sleep disorders, those with diagnosed TBI had an increased risk of incident sleep disorders over 14 years. Improved prevention and long-term management strategies for sleep are needed for veterans with TBI.

Intimate Partner Violence Among Female OEF/OIF/OND Veterans Who Were Evaluated for Traumatic Brain Injury in the Veterans Health Administration: A Preliminary Investigation

2017 ◽  
Vol 35 (13-14) ◽  
pp. 2422-2445 ◽  
Author(s):  
Katherine M. Iverson ◽  
Nina A. Sayer ◽  
Mark Meterko ◽  
Kelly Stolzmann ◽  
Pradeep Suri ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Intimate Partner Violence ◽  
Brain Injury ◽  
Partner Violence ◽  
Preliminary Investigation ◽  
Intimate Partner ◽  
Health Problems ◽  
Female Veterans ◽  
Health Administration ◽  
Physical And Mental Health

Many female veterans have deployed to Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND), and some experience traumatic brain injury (TBI). Although TBI is increasingly recognized as an important health issue for female OEF/OIF/OND veterans, there is little attention to stressful experiences that may exacerbate health problems or hinder recovery among veterans who may have experienced TBI. Lifetime intimate partner violence (IPV) is common among general samples of female veterans. Given the negative implications of IPV on women’s health, it is important to understand whether there is a relationship between lifetime IPV and health functioning among female veterans who have experienced possible TBI. This study provides an exploration of lifetime IPV and its associations with physical and mental health, as well as community reintegration, among female OEF/OIF/OND veterans who have been evaluated for TBI. The sample comprised 127 female veterans who participated in a larger study that examined reintegration among OEF/OIF/OND veterans who received a TBI evaluation in the Veterans Heath Administration (VHA) and completed an assessment of lifetime IPV. Primary and secondary data sources included survey responses (e.g., health symptoms and reintegration) and VHA administrative data (e.g., health diagnoses). Results indicated that nearly two thirds (63.0%) of women who completed a TBI evaluation reported lifetime IPV, though clinician-confirmed TBI was not associated with IPV. Women who experienced IPV, compared with those who did not, reported higher levels of neurobehavioral symptoms and were significantly more likely to have diagnoses of back pain (48.6% vs. 30.0%, respectively) and substance abuse (12.2% vs. 0%, respectively). Notwithstanding, women with and without lifetime IPV reported similar levels of reintegration. Findings provide evidence that lifetime IPV may be common among female OEF/OIF/OND veterans who are evaluated for TBI, and that IPV is associated with several treatable health problems among this population.

Two Approaches to Evaluating Sex Differences on Participation Outcomes Among Veterans With Traumatic Brain Injury

2021 ◽  
Vol 75 (Supplement_2) ◽  
pp. 7512500040p1-7512500040p1
Author(s):  
Alison M. Cogan ◽  
Jennifer A. Weaver ◽  
Trudy Mallinson ◽  
Theresa Bender Pape ◽  
Joel Scholten
Keyword(s):  
Traumatic Brain Injury ◽  
Sex Differences ◽  
Brain Injury ◽  
Financial Management ◽  
Self Report ◽  
Female Veterans ◽  
Men And Women ◽  
Male And Female ◽  
Participation Restrictions ◽  
Primary Author

Abstract Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. We used two different quantitative analytic approaches to examine whether there were sex differences in self-reported participation restrictions among male and female veterans with traumatic brain injury. Findings suggest that women have more challenges with leisure and employment and fewer challenges with residence and financial management than men. Total raw scores may obscure important differences in how men and women self-report participation restrictions. Primary Author and Speaker: Alison M. Cogan Contributing Authors: Jennifer A. Weaver, Trudy Mallinson, Theresa Bender Pape, and Joel Scholten

scholarly journals Traumatic Brain Injury and Dementia in Medicare Population: Differences in Risk Between Veterans and Non-Veterans

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 850-851
Author(s):  
Arseniy Yashkin
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Senile Dementia ◽  
Strong Predictor ◽  
Community Dwelling ◽  
Risk Scores ◽  
Increased Risk ◽  
Co Morbidity

Abstract The aim of this study was to assess differences in the effect of traumatic brain injury (TBI) on the onset of Alzheimer’s disease (AD) and other dementias between veteran and non-veteran respondents of the Health and Retirement Study as well as to measure the sensitivity of these differences to the introduction of controls for groups of demographic, medical co-morbidity and polygenic risk scores reflecting AD hallmarks. Using the Fine-Gray proportional hazards model we found that TBI was a strong predictor of dementia in community dwelling residents age 65+: for AD associated risk was 181% [Hazard Ratio (HR): 2.81; CI:2.05-3.86] sample-wide and 142% [HR: 2.42; CI:1.31-2.46] in veteran males. Effect magnitude decreased with the addition of risk-related control variables but remained associated with significantly increased risk. Large differences in risk were observed between veteran and non-veteran males for AD, vascular dementia, senile dementia, and dementia with Lewy Bodies

scholarly journals Sport-related concussions

2014 ◽  
Vol 8 (1) ◽  
pp. 14-19 ◽  
Author(s):  
Jéssica Natuline Ianof ◽  
Fabio Rios Freire ◽  
Vanessa Tomé Gonçalves Calado ◽  
Juliana Rhein Lacerda ◽  
Fernanda Coelho ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Behavioral Changes ◽  
American Football ◽  
Health Concern ◽  
Public Health Concern ◽  
Increased Risk ◽  
High Prevalence ◽  
Biomechanical Forces ◽  
The Brain

ABSTRACT Traumatic brain injury (TBI) is a major cause of lifelong disability and death worldwide. Sport-related traumatic brain injury is an important public health concern. The purpose of this review was to highlight the importance of sport-related concussions. Concussion refers to a transient alteration in consciousness induced by external biomechanical forces transmitted directly or indirectly to the brain. It is a common, although most likely underreported, condition. Contact sports such as American football, rugby, soccer, boxing, basketball and hockey are associated with a relatively high prevalence of concussion. Various factors may be associated with a greater risk of sport-related concussion, such as age, sex, sport played, level of sport played and equipment used. Physical complaints (headache, fatigue, dizziness), behavioral changes (depression, anxiety, irritability) and cognitive impairment are very common after a concussion. The risk of premature return to activities includes the prolongation of post-concussive symptoms and increased risk of concussion recurrence.

scholarly journals OUTCOME OF CEREBRAL CONTUSIONS DUE TO TRAUMATIC BRAIN INJURY

2020 ◽  
Vol 11 (1) ◽  
pp. 39-43
Author(s):  
Zubair Ahmed Khan ◽  
Habib sultan ◽  
Amir Aziz ◽  
Shahrukh Rizvi ◽  
Tauqeer Ahmed ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Hospital Stay ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Road Traffic Accidents ◽  
Male And Female ◽  
Duration Of Hospital Stay ◽  
History Of ◽  
Age Range

ABSTRACT:BACKGROUND & OBJECTIVE: To compare the results of surgically operated vs conservatively treated patients of cerebral contusions due to traumatic brain injury. METHODOLOGY: This comparative study was conducted from January 2012 to December 2014 at the department of Neurosurgery, PGMI Lahore General Hospital, Lahore. A total of 50 patients were included in this study of both gender (male and female) and in the age range of 15-65 years. In our study 20 patients were managed conservatively while other 30 patients were operated for cerebral contusions. The mode of injury in our study was road traffic accidents and history of falls. RESULTS: Out of 50 patients, there were 41 (82%) males and 09 (18%) female patients. Their age ranged from 15 - 65 years. In this study the overall mean age is 38.36 years. The maximum numbers of patients were in their third and fourth decades of life. In our study the duration of hospital stay in conservatively managed patients was longer as compared to surgically treated patients who were discharged earlier. Mortality rate in surgically managed patients having a GCS ranged between 09 to 12 was very low contrary to the conservatively managed group, similarly the rate of delayed contusion formation and edema was also low in surgically managed patients as compared to those who were managed conservatively. CONCLUSION: Surgically managed patients of cerebral contusions in traumatic brain injury has better outcome and decreased hospital stay as compared to conservatively managed patients.

scholarly journals Traumatic Brain Injury and Risk of Dementia and Alzheimer’s Disease: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Dongqing Gu ◽  
Shan Ou ◽  
Guodong Liu
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Subsequent Development ◽  
Medical Monitoring ◽  
Increased Risk

Introduction: Previous studies have investigated the potential role of traumatic brain injury (TBI) in subsequent development of dementia and Alzheimer’s disease (AD) but reported inconsistent results. We aim to determine the association between TBI and subsequent occurrence of dementia and AD. Methods: We performed a systematic search in PubMed and Web of Science for studies that quantitatively investigated the association between TBI and risk of dementia and AD and were published on or before September 21, 2021. A random-effect model was used to combine the estimates. Results: Twenty-five eligible articles were included in this meta-analysis. The results suggested that TBI was associated with an increased risk of dementia (pooled odds ratio [OR] = 1.81, 95% confidence interval [CI] = 1.53 - 2.14). However, no association was observed between TBI and Alzheimer’s disease (pooled OR = 1.02, 95% CI = 0.91 - 1.15). In the subgroup analysis, TBI with loss of consciousness was not associated with risk of dementia (pooled OR = 0.96, 95% CI = 0.84 - 1.09). Besides, Asian ethnicity, male gender, and mean age of the participants less than 65 were associated with a higher risk of dementia. Conclusion: Our study suggests an increased risk of dementia among individuals with TBI, highlighting the need for more intensive medical monitoring and health education in individuals with TBI. Biological mechanisms linking TBI and the development of dementia are needed in future studies.

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