Citation

Tabio L, Walker R, Crane PK, Gibbons LE, Kumar R, Power MC, Kelley AS, Larson EB, Dams-O'connor K. Arch. Phys. Med. Rehabil. 2021; ePub(ePub): ePub.

Copyright

(Copyright © 2021, Elsevier Publishing)

DOI

10.1016/j.apmr.2021.06.018

PMID

unavailable

Abstract

OBJECTIVE: To determine associations of traumatic brain injury (TBI) and military employment with activities of daily living (ADL) in late life. SETTING: Community-based integrated healthcare delivery system. PARTICIPANTS: Male (n=2066) and female (n=2887), aged 65+ and dementia-free.

DESIGN: Population-based prospective cohort study with biennial follow-up and censoring at time of dementia diagnosis. MAIN OUTCOME MEASURES: ADL difficulties at baseline and accumulation during follow-up.

RESULTS: TBI with loss of consciousness (LOC) before age 40 was associated with slightly higher ADL difficulty at baseline for females (RR=1.44, 95% CI: 1.08-1.93, p=0.01). For males, TBI with LOC at any age was associated with greater ADL difficulty at baseline (age <40: RR=1.58, 95% CI: 1.20 - 2.08, p = 0.001; age 40+: RR=2.14, 95% CI: 1.24 - 3.68, p = 0.006). TBI with LOC was not associated with the rate of accumulation of ADL difficulties over time in males or females. There was no evidence of an association between military employment and either outcome, nor of an interaction between military employment and TBI with LOC.

FINDINGS were consistent across a variety of sensitivity analyses.

CONCLUSION: Further investigation into factors underlying greater late-life functional impairment among TBI survivors is warranted.

Language: en

Keywords

older adults; traumatic brain injury; longitudinal outcomes; military employment activities of daily living