Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jul-Aug;37(4):E242-E248.
doi: 10.1097/HTR.0000000000000719. Epub 2021 Jul 26.

Repetitive Traumatic Brain Injury Among Older Adults

Aparna Vadlamani Chauhan  1 , Jack Guralnik, Susan dosReis, John D Sorkin, Neeraj Badjatia, Jennifer S Albrecht
Affiliations

Repetitive Traumatic Brain Injury Among Older Adults

Aparna Vadlamani Chauhan et al. J Head Trauma Rehabil. 2022 Jul-Aug.

Abstract

Objective: To determine the incidence of and assess risk factors for repetitive traumatic brain injury (TBI) among older adults in the United States.

Design: Retrospective cohort study.

Setting: Administrative claims data obtained from the Centers for Medicare & Medicaid Services' Chronic Conditions Data Warehouse.

Participants: Individuals 65 years or older and diagnosed with TBI between July 2008 and September 2012 drawn from a 5% random sample of US Medicare beneficiaries.

Main measures: Repetitive TBI was identified as a second TBI occurring at least 90 days after the first occurrence of TBI following an 18-month TBI-free period. We identified factors associated with repetitive TBI using a log-binomial model.

Results: A total of 38 064 older Medicare beneficiaries experienced a TBI. Of these, 4562 (12%) beneficiaries sustained at least one subsequent TBI over up to 5 years of follow-up. The unadjusted incidence rate of repetitive TBI was 3022 (95% CI, 2935-3111) per 100 000 person-years. Epilepsy was the strongest predictor of repetitive TBI (relative risk [RR] = 1.44; 95% CI, 1.25-1.56), followed by Alzheimer disease and related dementias (RR = 1.32; 95% CI 1.20-1.45), and depression (RR = 1.30; 95% CI, 1.21-1.38).

Conclusions: Injury prevention and fall-reduction interventions could be targeted to identify groups of older adults at an increased risk of repetitive head injury. Future work should focus on injury-reduction initiatives to reduce the risk of repetitive TBI as well as assessment of outcomes related to repetitive TBI.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

References

    1. Taylor CA, Bell JM, Breiding MJ, Xu L. Traumatic Brain Injury-Related Emergency Department Visits, Hospitalizations, and Deaths - United States, 2007 and 2013. Morbidity and mortality weekly reportSurveillance summaries (Washington, DC: 2002). 2017;66(9):1–16. - PMC - PubMed
    1. Gardner RC, Dams-O’Connor K, Morrissey MR, Manley GT. Geriatric Traumatic Brain Injury: Epidemiology, Outcomes, Knowledge Gaps, and Future Directions. J Neurotrauma. 2018;35(7):889–906. - PMC - PubMed
    1. Gardner RC, Burke JF, Nettiksimmons J, Kaup A, Barnes DE, Yaffe K. Dementia risk after traumatic brain injury vs nonbrain trauma: the role of age and severity. JAMA neurology. 2014;71(12):1490–1497. - PMC - PubMed
    1. Coronado VG, Thomas KE, Sattin RW, Johnson RL. The CDC traumatic brain injury surveillance system: characteristics of persons aged 65 years and older hospitalized with a TBI. J Head Trauma Rehabil. 2005;20(3):215–228. - PubMed
    1. McIntyre A, Mehta S, Janzen S, Aubut J, Teasell RW. A meta-analysis of functional outcome among older adults with traumatic brain injury. NeuroRehabilitation. 2013;32(2):409–414. - PubMed

Publication types