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

Publication ,  Journal Article
Kornblith, E; Peltz, CB; Xia, F; Plassman, B; Novakovic-Apopain, T; Yaffe, K
Published in: Neurology
September 29, 2020

OBJECTIVE: To investigate whether sex and race differences exist in dementia diagnosis risk associated with traumatic brain injury (TBI) among older veterans. METHODS: Using Fine-Gray regression models, we investigated incident dementia diagnosis risk with TBI exposure by sex and race. RESULTS: After 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. CONCLUSIONS: In 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.

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Published In

Neurology

DOI

EISSN

1526-632X

Publication Date

September 29, 2020

Volume

95

Issue

13

Start / End Page

e1768 / e1775

Location

United States

Related Subject Headings

  • Veterans
  • United States Department of Veterans Affairs
  • United States
  • Sex Factors
  • Race Factors
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Humans
  • Female
 

Citation

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Chicago
ICMJE
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Kornblith, E., Peltz, C. B., Xia, F., Plassman, B., Novakovic-Apopain, T., & Yaffe, K. (2020). Sex, race, and risk of dementia diagnosis after traumatic brain injury among older veterans. Neurology, 95(13), e1768–e1775. https://doi.org/10.1212/WNL.0000000000010617
Kornblith, Erica, Carrie B. Peltz, Feng Xia, Brenda Plassman, Tatjana Novakovic-Apopain, and Kristine Yaffe. “Sex, race, and risk of dementia diagnosis after traumatic brain injury among older veterans.Neurology 95, no. 13 (September 29, 2020): e1768–75. https://doi.org/10.1212/WNL.0000000000010617.
Kornblith E, Peltz CB, Xia F, Plassman B, Novakovic-Apopain T, Yaffe K. Sex, race, and risk of dementia diagnosis after traumatic brain injury among older veterans. Neurology. 2020 Sep 29;95(13):e1768–75.
Kornblith, Erica, et al. “Sex, race, and risk of dementia diagnosis after traumatic brain injury among older veterans.Neurology, vol. 95, no. 13, Sept. 2020, pp. e1768–75. Pubmed, doi:10.1212/WNL.0000000000010617.
Kornblith E, Peltz CB, Xia F, Plassman B, Novakovic-Apopain T, Yaffe K. Sex, race, and risk of dementia diagnosis after traumatic brain injury among older veterans. Neurology. 2020 Sep 29;95(13):e1768–e1775.

Published In

Neurology

DOI

EISSN

1526-632X

Publication Date

September 29, 2020

Volume

95

Issue

13

Start / End Page

e1768 / e1775

Location

United States

Related Subject Headings

  • Veterans
  • United States Department of Veterans Affairs
  • United States
  • Sex Factors
  • Race Factors
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Humans
  • Female