TOPLINE

Traumatic brain injury (TBI) was associated with higher incidence rates of stroke, dementia, epilepsy, and Parkinson’s disease (PD) both before and after the injury in older adults, a retrospective study showed.

METHODOLOGY

• A US cohort study included data from 13,801 patients with acute TBI (mean age, 77.8 years; 96.5% male; 81% non-Hispanic White individuals) from 1999 to 2021 obtained from the US Veterans Health Affairs database.
• A total of 41,403 individuals without TBI (non-TBI cohort) were matched 3:1 with patients with TBI (TBI cohort) on the basis of age at visit, sex, race or ethnicity, and visit date.
• The incidence rates (per 1000 person-years) of stroke, dementia, epilepsy, and PD during the pre-TBI period (a year before TBI) were compared between patients with TBI and matched individuals without TBI.
• In patients with TBI, the incidence rates (per 1000 person-years) of stroke, dementia, epilepsy, and PD were compared between the pre-TBI period and the post-TBI period (up to 1 year after TBI or until death).

TAKEAWAY

• Patients with TBI had a higher incidence rate of stroke (63.5 vs 20.1; incidence rate ratio [IRR], 3.2), PD (9.6 vs 3.2; IRR, 3.0), dementia (58.1 vs 18.5; IRR, 3.1), and epilepsy (11.6 vs 2.6; IRR, 4.4) in the pre-TBI period than those in the non-TBI cohort.
• Patients with TBI had higher incidence rates of stroke (113.6 vs 63.5; IRR, 1.79), epilepsy (26.5 vs 11.6; IRR, 2.29), and dementia (72.3 vs 58.1; IRR, 1.24) in the post-TBI period than in the pre-TBI period.
• The incidence of PD did not differ significantly between the pre- and post-TBI periods.

IN PRACTICE

“Our findings raise the possibility that dementia, stroke, epilepsy, and Parkinson’s disease are themselves risk factors for TBI in older people. Neurological diseases often impair motor control, balance, gait, coordination, and thinking skills — all of which make people more likely to fall, which is the main cause of TBI in older adults,” said the lead author of the study in a press release.

SOURCE

The study, led by Carrie Peltz, PhD, Northern California Institute for Research and Education, San Francisco, was published online on June 17 in Neurology.

LIMITATIONS 

Patients with severe TBI who died within a year and those with mild TBI who did not seek medical care or receive imaging were excluded. Data on previous service-related exposures that may have affected the risk for TBI and neurologic conditions were unavailable. Longer latency effects were not captured. The findings were not generalizable to nonveteran or civilian populations. Mild or early-stage disease may have not been captured, leading to misclassification.

DISCLOSURES

The study was funded by the Department of Defense and US Army Medical Research and Development Command. The investigators reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.