Abstract Details

Title Is Mild Traumatic Brain Injury associated with Early Onset Dementia when evaluating only validated cases of Dementia?

Topic Aging, Dementia, and Behavioral Neurology

Presentation(s) S34 - Aging and Dementia: Risk Factors, Biomarkers, and Neuropathology (1:22 PM-1:33 PM)

Poster/Presentation
Number 003

Background Increasing evidence suggests that TBI can accelerate age-related neurodegeneration and increase the risk of dementia. While a recent study found a significant relationship between mild TBI (mTBI) and dementia, the extent to which this relationship exists for mTBI and EOD is unclear. Existing methodologies, such as use of ICD-9 diagnostic codes have been found to be ineffective in identifying EOD in civilian samples (58% positive predictive value [PPV]). A recent study among younger Veterans similarly found that ICD-9 codes used to identify dementia had only about 28% PPV. Thus, veracity of the association between mTBI and dementia found in recent studies is uncertain.

Objective Examine the association between severity of Traumatic Brain Injury (TBI) and Early Onset Dementia (EOD) among Veterans with a validated dementia diagnosis.

Design/Methods From 1,724 Veterans <65 years of age with 2 or more dementia diagnoses based on ICD-9 codes recommended by Veterans Affairs (VA) Dementia Steering Committee, we identified a random sample of 286 cases of EOD. EOD diagnosis was validated by medical chart abstractions and neuropsychologist panel reviews for 153 cases. We matched the validated cases based on age, sex, race/ethnicity, year of entry to VA care, and branch of service to 2490 controls with no indicators of dementia or cognitive impairment. TBI severity was defined using multiple Department of Defense and VA data sources. We used conditional logistic regression to examine the association of TBI severity with EOD.

Results Even after controlling for mental health and other comorbid conditions mTBI was significantly associated with validated EOD [aOR( 95%CI): mTBI-4.5(2.4-8.9), moderate/severe TBI-21.3(8.4-54.3)]. Stroke, depression, PTSD, and headache were also associated with higher odds of EOD.

Conclusions These findings further strengthen the reported association of the mTBI with EOD among Veterans and highlight the need for use of validated algorithms for accurate dementia surveillance in this population.

Authors/Disclosures
Hari Krishna Raju Sagiraju, MD, MBBS, PhD, MPH (Division of Epidemiology, University of Utah) PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Megan Amuan	No disclosure on file
	No disclosure on file
Mary Jo Pugh, PhD, RN, FAAN	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. The institution of Dr. Pugh has received research support from Sanofi.

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