Abstract Details

Title Severity of Traumatic Brain Injury and Dementia in Veterans from the Afghanistan and Iraq Wars

Topic Aging and Dementia

Presentation(s) P03 - (-)

Poster/Presentation
Number 099

Objective

Background BACKGROUND: TBI is the signature injury of the wars in Afghanistan and Iraq, with a majority being mild TBI (mTBI). Symptoms of TBI overlap with symptoms of PTSD in this population, and findings from several studies suggest that PTSD symptoms account for significant variance on cognitive measures. While TBI is associated with risk of neurodegeneration, studies linking mild TBI to dementia are limited and no studies have examined the contributing effect of PTSD to dementia 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 dementia using validated algorithms. TBI was classified as severe (includes penetrating), moderate, or mild based on the most severe type coded. We controlled for age, sex, race, and PTSD.

Results RESULTS: Of the 303,716 individuals who received VA care in 2010-2011, 571 (0.2%) were diagnosed with dementia. The odds of diagnosis with severe TBI (205.6; 95% CI 90.0-470.1) was significantly higher than moderate (27.3; 95% CI 17.3-42.9) or mild (5.2; 95% CI 2.9-9.2; p<.001) TBI. PTSD diagnosis was associated with reduced odds of dementia (.41; 95% CI .27-.62). There was no significant interaction between TBI and PTSD.

Conclusions CONCLUSIONS: As expected, the relationship between dementia and TBI is strongest in more severe TBI, but the association with mTBI remained significant after controlling for demographic characteristics. The impact of mTBI remained the same after controlling for PTSD. Unlike prior analyses that found an interaction between mTBI and PTSD for cognitive impairment, and there was no significant interaction between TBI severity and PTSD for dementia.

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
Mario Masellis, MD (Sunnybrook Health Sciences Centre)	Dr. Masellis has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Arkuda Therapeutics. Dr. Masellis has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Ionis. Dr. Masellis has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alector. Dr. Masellis has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Wave Life Sciences. The institution of Dr. Masellis has received research support from Canadian Institutes of Health Research. The institution of Dr. Masellis has received research support from Ontario Brain Institute. The institution of Dr. Masellis has received research support from Weston Brain Institute. The institution of Dr. Masellis has received research support from Washington University. The institution of Dr. Masellis has received research support from Alector. Dr. Masellis has received publishing royalties from a publication relating to health care.

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