TY  - JOUR
PY  - 2021//
TI  - The impact of age and severity on dementia after traumatic brain injury: a comparison study
JO  - Neurosurgery
A1  - Stopa, Brittany M.
A1  - Tahir, Zabreen
A1  - Mezzalira, Elisabetta
A1  - Boaro, Alessandro
A1  - Khawaja, Ayaz
A1  - Grashow, Rachel
A1  - Zafonte, Ross D.
A1  - Smith, Timothy R.
A1  - Gormley, William B.
A1  - Izzy, Saef
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - BACKGROUND: Growing evidence associates traumatic brain injury (TBI) with increased risk of dementia, but few studies have evaluated associations in patients younger than 55 yr using non-TBI orthopedic trauma (NTOT) patients as controls to investigate the influence of age and TBI severity, and to identify predictors of dementia after trauma. <br><br>OBJECTIVE: To investigate the relationship between TBI and dementia in an institutional group. <br><br>METHODS: Retrospective cohort study (2000-2018) of TBI patients aged 45 to 100 yr vs NTOT controls. Primary outcome was dementia after TBI (followed ≤10 yr). Cox proportional hazards models were used to assess risk of dementia; logistic regression models assessed predictors of dementia. <br><br>RESULTS: Among 24 846 patients, TBI patients developed dementia (7.5% vs 4.6%) at a younger age (78.6 vs 82.7 yr) and demonstrated higher 10-yr mortality than controls (27% vs 14%; P < .001). Mild TBI patients had higher incidence of dementia (9%) than moderate/severe TBI (5.4%), with lower 10-yr mortality (20% vs 31%; P < .001). Risk of dementia was significant in all mild TBI age groups, even 45 to 54 yr (hazard ratio 4.1, 95% CI 2.7-7.8). A total of 10-yr cumulative incidence was higher in mild TBI (14.4%) than moderate/severe TBI (11.3%) and controls (6.8%) (P < .001). Predictors of dementia include TBI, sex, age, hypertension, hyperlipidemia, stroke, depression, anxiety, and Injury Severity Score. <br><br>CONCLUSION: Mild and moderate/severe TBI patients experienced higher incidence of dementia, even in the youngest group (45-54 yr old), than NTOT controls. All TBI patients, especially middle-aged adults with minor injury who are more likely to be overlooked, should be monitored for dementia.<p />  <p>Language: en</p>
LA  - en
SN  - 0148-396X
UR  - http://dx.doi.org/10.1093/neuros/nyab297
ID  - ref1
ER  -