Abstract Details

Title Medical and Psychiatric Conditions Occurring after Traumatic Brain Injury Increase the Risk of Dementia

Topic Neuro Trauma, Critical Care, and Sports Neurology

Presentation(s) Sports Neurology and Neuro Trauma Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 002

Objective To examine the association between multisystem morbidities developing after traumatic brain injury (TBI) and the risk of dementia.

Background There is a great body of work on the risk of dementia following TBI and the effect of preexisting comorbidities on that risk; however, the possible link between the multisystem morbidities that develop after TBI and the risk of dementia has not been thoroughly explored.

Design/Methods We performed a retrospective cohort study of 2765 patients with mild and moderate-severe TBI and, non-head orthopedic trauma controls, aged 40 years or older, from a hospital-based electronic medical registry, with 10-year follow-up. Patients with preexisting comorbidities and dementia were excluded. The morbidities were defined using the ICD codes. Cox proportional hazards model with time varying covariates was used to test the association between TBI and morbidities occurring after TBI with dementia.

Results 51% of patients were male with a median age of 54 years (IQR 47-68). Dementia was diagnosed in 1.9% of mild TBI, 2.6% of moderate-severe TBI, and 1% of control groups over 10-years follow-up period. After multivariable adjustment, both mild (HR 2.0; [95%CI 1.3-3.2]) and moderate-severe TBI (HR 3.0; [95%CI 1.8-5.1]) were independently associated with dementia. On multivariable analysis, peripheral arterial disease (HR 2.2; [95% CI 1.1-4.8]), ischemic stroke (HR 3.9; [95% CI 2.1-7.1]), depression (HR 2.7; [95% CI 1.7-5.2]), alcohol misuse (HR 2.9; [95% CI 1.2-6.9]), and age> 60 (HR 6.6; [95% CI 4.4-9.9]) were independent predictors of dementia.

Conclusions Multiple medical and psychiatric diseases that develop after TBI are independent risk factors for dementia. These data may help guide prospective studies and could form the basis for improved risk assessment and preventative measures in this patient group.

Authors/Disclosures
Farid Radmanesh, MD, MPH PRESENTER	Dr. Radmanesh has nothing to disclose.
	No disclosure on file
Taha Yahya	Taha Yahya has nothing to disclose.
	No disclosure on file
Hadi Abou-El-Hassan, MD	Dr. Abou-El-Hassan has nothing to disclose.
Samuel Snider, MD (Massachusetts General Hospital, Brigham, Harvard)	Dr. Snider has nothing to disclose.
Steven K. Feske, MD (Boston Medical Center, Neurology Department)	Dr. Feske has received publishing royalties from a publication relating to health care.
Saef Izzy, MD, FAAN (Brigham and Women'S Hospital, Harvard Medical School)	The institution of Dr. Izzy has received research support from NINDS. The institution of Dr. Izzy has received research support from The Gillian Reny Stepping Strong Center for Trauma Innovation. Dr. Izzy has received publishing royalties from a publication relating to health care.

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