Research Reports - Prevalence, associated factors, mood and cognitive outcomes of traumatic brain injury in later life
Int J Geriatr Psychiatry. 2015 Feb 20
Almeida OP(1), Hankey GJ, Yeap BB, Golledge J, Flicker L
BACKGROUND: The incidence of traumatic brain injury (TBI) is rising, as are its
neuropsychiatric complications. This study aims to determine (1) the prevalence
of TBI, (2) the association between history of past TBI and sociodemographic,
lifestyle and clinical factors, and (3) the risk of depression and cognitive
impairment in later life associated with exposure to TBI.
METHODS: Cross-sectional study of a community-derived sample of 5486 Australian
men aged 70-89 years. Information on TBI was retrieved from the Western
Australian Data Linkage System (WADLS) and via self-report. We used the WADLS and
self-report to ascertain history of past depression, and the Geriatric Depression
Scale 15-items to assess current clinically significant symptoms of depression,
defined by score ≥7. We defined cognitive impairment by a mini-mental state
examination score <24 or a WADLS diagnosis of dementia.
RESULTS: Nine hundred fifty-three men had history of TBI (17.4%). Factors
associated with TBI included coronary heart disease, stroke, poor self-perceived
physical health and falls. TBI increased the odds ratio of past (odds ratio
(OR) = 1.55, 95% confidence interval (CI) = 1.21, 1.99) and current depression
(OR = 1.77, 95% CI = 1.36, 2.32), as well as of cognitive impairment (OR = 1.23,
95% CI = 1.00, 1.51). The population fractions of depression and cognitive
impairment attributable to TBI were 6.9% (95% CI = 3.3%, 10.3%) and 3.4% (95%
CI = 0.0%, 6.9%).
CONCLUSIONS: History of TBI is common in older men, and is associated with
increased risk of depression and cognitive impairment. If this association is
truly causal, then the effective reduction of events leading to TBI (e.g., motor
vehicle accidents and falls) may also decrease the prevalence of depression and
cognitive impairment in later life.