Abstract Details

Title The Nexus of Traumatic Brain Injury and Mild Cognitive Impairment

Topic Aging and Dementia

Presentation(s) P03 - (-)

Poster/Presentation
Number 102

Objective

Background BACKGROUND: TBI is the signature injury of the wars in Afghanistan and Iraq, with a majority being mild TBI (mTBI). TBI may cause MCI and is associated with increased risk of neurodegeneration, highlighting a need for accurate early diagnosis and appropriate follow-up of TBI patients. MCI is a useful concept for early symptomatic diagnosis of Alzheimer's disease; however, no studies have examined the link between TBI severity and MCI, nor the contributing effect of PTSD to cognitive loss in TBI.

Design/Methods DESIGN/METHODS: We used diagnostic data (ICD-9CM codes) from the Department of Veterans Affairs (2010-2011) to identify individuals with TBI and MCI using validated algorithms. TBI was classified as penetrating (pTBI), severe, moderate, or mild based on the most severe type coded. To address potential confounding with PTSD we created a TBIxPTSD interaction term, and used logistic regression analysis to examine the odds of TBIxPTSD categories associated with MCI compared to those without TBI or PTSD.

Results RESULTS: Of the 303,716 individuals who received VA care in 2010-2011, 2,155 (0.71%) were diagnosed with MCI. The odds of MCI diagnosis with pTBI+PTSD was lower than pTBI alone (albeit not significantly; 116.7:; 95% CI 40.9-333.4 vs 216.6; 95% CI 72.4-647.6; p>.1), in contrast to mTBI+PTSD, which was significantly higher than mTBI alone (29.2; 95% CI 23.2-36.8 vs 52.9; 95% CI 44.1-63.4 respectively; p<.001).

Conclusions CONCLUSIONS: The relationship between MCI and TBI is strongest in more severe TBI, and for severe TBI comorbid PTSD was not significantly different than TBI alone. While MCI was also associated with mTBI alone, having comorbid PTSD conferred significantly higher odds of MCI. These data suggest that PTSD should be included in epidemiological study of mTBI and neurodegenerative disorders.

Authors/Disclosures
Mary Jo Pugh, PhD, RN, FAAN PRESENTER	The institution of Dr. Pugh has received research support from Department of Defense, Epilepsy Research Program. The institution of Dr. Pugh has received research support from VA Health Services Research and Development Service. The institution of Dr. Pugh has received research support from VA Rehabilitation Research and Development Service. The institution of Dr. Pugh has received research support from Congressionally Directed Research Programs.
	No disclosure on file
	No disclosure on file
Gustavo C. Roman, MD, FAAN (Methodist Neurological Institute)	The institution of Dr. Roman has received research support from Brain Chamistry Labs.
Thomas A. Kent, MD	No disclosure on file
	No disclosure on file

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