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Cited by 451Traumatic Brain Injury ResearchTraumatic Brain Injury and Neurovascular DisturbancesDementia and Cognitive Impairment Research

The DOI matches its Crossref record, with a small difference in title or year; 37 of the 37 references it cites were found in a registry or an index.

Dementia Risk After Traumatic Brain Injury vs Nonbrain Trauma: The Role of Age and Severity

Open access
Gardner, Raquel C., Burke, James F., Nettiksimmons, Jasmine, Kaup, Allison, Barnes, Deborah E., Yaffe, Kristine·2014·JAMA Neurology
DOI 10.1001/jamaneurol.2014.2668PMC PMC4318558
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Abstract

IMPORTANCE: Epidemiologic evidence regarding the importance of traumatic brain injury (TBI) as a risk factor for dementia is conflicting. Few previous studies have used patients with non-TBI trauma (NTT) as controls to investigate the influence of age and TBI severity. OBJECTIVE: To quantify the risk of dementia among adults with recent TBI compared with adults with NTT. DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study was performed from January 1, 2005, through December 31, 2011 (follow-up, 5-7 years). All patients 55 years or older diagnosed as having TBI or NTT in 2005 and 2006 and who did not have baseline dementia or die during hospitalization (n = 164,661) were identified in a California statewide administrative health database of emergency department (ED) and inpatient visits. EXPOSURES: Mild vs moderate to severe TBI diagnosed by Centers for Disease Control and Prevention criteria using International Classification of Diseases, Ninth Revision (ICD-9)codes, and NTT, defined as fractures excluding fractures of the head and neck, diagnosed using ICD-9 codes. MAIN OUTCOMES AND MEASURES: Incident ED or inpatient diagnosis of dementia (using ICD-9 codes) 1 year or more after initial TBI or NTT. The association between TBI and risk of dementia was estimated using Cox proportional hazards models before and after adjusting for common dementia predictors and potential confounders. We also stratified by TBI severity and age category (55-64, 65-74, 75-84, and ≥85 years). RESULTS: A total of 51,799 patients with trauma (31.5%) had TBI. Of these, 4361 (8.4%) developed dementia compared with 6610 patients with NTT (5.9%) (P < .001). We found that TBI was associated with increased dementia risk (hazard ratio [HR], 1.46; 95% CI, 1.41-1.52; P < .001). Adjustment for covariates had little effect except adjustment for age category (fully adjusted model HR, 1.26; 95% CI, 1.21-1.32; P < .001). In stratified adjusted analyses, moderate to severe TBI was associated with increased risk of dementia across all ages (age 55-64: HR, 1.72; 95% CI, 1.40-2.10; P < .001; vs age 65-74: HR, 1.46; 95% CI, 1.30-1.64; P < .001), whereas mild TBI may be a more important risk factor with increasing age (age 55-64: HR, 1.11; 95% CI, 0.80-1.53; P = .55; vs age 65-74: HR, 1.25; 95% CI, 1.04-1.51; P = .02; age interaction P < .001). CONCLUSIONS AND RELEVANCE: Among patients evaluated in the ED or inpatient settings, those with moderate to severe TBI at 55 years or older or mild TBI at 65 years or older had an increased risk of developing dementia. Younger adults may be more resilient to the effects of recent mild TBI than older adults.

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  • Advance care planning might reduce carers' uncertainty in decision making and improve perceptions of quality of care.

    “Advance care planning might, however, reduce carers' uncertainty in decision making and improve perceptions of quality of care.310”

    From Dementia prevention, intervention, and care: 2020 report of the Lancet Commission (2020) · cites this paper as [310]

    The Introduction describes a study of traumatic brain injury and subsequent dementia risk, and the Methods describe its use of hospital and emergency-department records (pages unavailable). Searches for advance care planning, carers’ decision-making uncertainty, and perceived quality of care found no passage addressing those topics. (LLM, conf=0.76)

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Metadata

Authors
Gardner, R. C., Burke, J. F., Nettiksimmons, J., Kaup, A., Barnes, D. E., & Yaffe, K.
Affiliations
  • San Francisco VA Medical Center (US)
  • University of Michigan (US)
Corresponding author
Gardner, Raquel C.
ORCID
Venue
JAMA Neurology
Publisher
American Medical Association (AMA)
Published
2014-12-01
Volume
71
Issue
12
Pages
1490
ISSN
2168-6149 (ISSN-L)
DOI
10.1001/jamaneurol.2014.2668
PMC
PMC4318558
OpenAlex
W2034354239
Cited by
451
References
37
Citations by year
2026: 27 · 2025: 32 · 2024: 39 · 2023: 41 · 2022: 42 · 2021: 47 · 2020: 37 · 2019: 50 · 2018: 33 · 2017: 44 · 2016: 32 · 2015: 25 · 2014: 1
FWCI
25.67
Type
journal article
Language
en
Open access
Locations
  • JAMA Neurology (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
  • National Institute on Aging (K24AG031155, T32AG023481, P30AG044281, P50AG023501)
  • National Institute of Neurological Disorders and Stroke (K08NS082597)
Topics
  • Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury Research
  • Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury and Neurovascular Disturbances
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
Keywords
traumatic brain injury, dementia risk, fracture, TBI severity, mild traumatic brain injury, moderate to severe traumatic brain injury, older adults, age-stratified analysis, emergency department visits, inpatient visits, trauma epidemiology, dementia risk factors, administrative health data, cohort studies, hazard ratio, confounding by age
MeSH terms
Age Factors, Aged, Aged, 80 and over, Brain Injuries, California, Dementia, Female, Follow-Up Studies, Humans, Male, Middle Aged, Risk, Trauma Severity Indices, Fractures, Bone

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