Evidence map›Paper›PMID 37816634›Full record

ArticleNeurology2023

Associations Between Head Injury and Subsequent Risk of Falls: Results From the Atherosclerosis Risk in Communities (ARIC) Study.

Katherine J Hunzinger, Connor A Law, Holly Elser, Alexa E Walter, B Gwen Windham, Priya Palta, Stephen P Juraschek, Caitlin W Hicks, Rebecca F Gottesman, Andrea L C Schneider

Open access · greenAbstract read
In one paragraph

Article in Neurology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
6.6field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 9 citations in OpenAlex.

  1. Review
  2. Article
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  8. Article
  9. Associations Between Prior Head Injury, Physical Functioning, and Frailty in the Atherosclerosis Risk in Communities Study.The journals of gerontology. Series A, Biological sciences and medical sciences · 2024
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 1 institution in 2 countries.

Katherine J HunzingerFrom the Department of Exercise Science (K.J.H.), Thomas Jefferson University; Department of Neurology (C.A.L., A.E.W., A.L.S.), University of Pennsylvania Perelman School of Medicine; Department of Neurology (H.E.), Hospital of the University of Pennsylvania; Memory Impairment and Neurodegenerative Dementia (MIND) Center (B.G.W.), University of Mississippi Medical Center; Department of Neurology (P.P.), University of North Carolina Chapel Hill; Department of Medicine (S.P.J.), Beth Israel Deaconess Medical Center; Department of Surgery (C.W.H.), Johns Hopkins University School of Medicine; National Institute of Neurological Disorders and Stroke (R.F.G.); Department of Biostatistics (A.L.S.), Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine; and Penn Injury Science Center (A.L.S.), University of Pennsylvania. katherine.hunzinger@jefferson.edu.ORCID 0000-0002-4599-8543
Connor A LawFrom the Department of Exercise Science (K.J.H.), Thomas Jefferson University; Department of Neurology (C.A.L., A.E.W., A.L.S.), University of Pennsylvania Perelman School of Medicine; Department of Neurology (H.E.), Hospital of the University of Pennsylvania; Memory Impairment and Neurodegenerative Dementia (MIND) Center (B.G.W.), University of Mississippi Medical Center; Department of Neurology (P.P.), University of North Carolina Chapel Hill; Department of Medicine (S.P.J.), Beth Israel Deaconess Medical Center; Department of Surgery (C.W.H.), Johns Hopkins University School of Medicine; National Institute of Neurological Disorders and Stroke (R.F.G.); Department of Biostatistics (A.L.S.), Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine; and Penn Injury Science Center (A.L.S.), University of Pennsylvania.ORCID 0009-0008-5084-7089
Holly ElserFrom the Department of Exercise Science (K.J.H.), Thomas Jefferson University; Department of Neurology (C.A.L., A.E.W., A.L.S.), University of Pennsylvania Perelman School of Medicine; Department of Neurology (H.E.), Hospital of the University of Pennsylvania; Memory Impairment and Neurodegenerative Dementia (MIND) Center (B.G.W.), University of Mississippi Medical Center; Department of Neurology (P.P.), University of North Carolina Chapel Hill; Department of Medicine (S.P.J.), Beth Israel Deaconess Medical Center; Department of Surgery (C.W.H.), Johns Hopkins University School of Medicine; National Institute of Neurological Disorders and Stroke (R.F.G.); Department of Biostatistics (A.L.S.), Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine; and Penn Injury Science Center (A.L.S.), University of Pennsylvania.ORCID 0000-0003-1781-904X
Alexa E WalterFrom the Department of Exercise Science (K.J.H.), Thomas Jefferson University; Department of Neurology (C.A.L., A.E.W., A.L.S.), University of Pennsylvania Perelman School of Medicine; Department of Neurology (H.E.), Hospital of the University of Pennsylvania; Memory Impairment and Neurodegenerative Dementia (MIND) Center (B.G.W.), University of Mississippi Medical Center; Department of Neurology (P.P.), University of North Carolina Chapel Hill; Department of Medicine (S.P.J.), Beth Israel Deaconess Medical Center; Department of Surgery (C.W.H.), Johns Hopkins University School of Medicine; National Institute of Neurological Disorders and Stroke (R.F.G.); Department of Biostatistics (A.L.S.), Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine; and Penn Injury Science Center (A.L.S.), University of Pennsylvania.
B Gwen WindhamFrom the Department of Exercise Science (K.J.H.), Thomas Jefferson University; Department of Neurology (C.A.L., A.E.W., A.L.S.), University of Pennsylvania Perelman School of Medicine; Department of Neurology (H.E.), Hospital of the University of Pennsylvania; Memory Impairment and Neurodegenerative Dementia (MIND) Center (B.G.W.), University of Mississippi Medical Center; Department of Neurology (P.P.), University of North Carolina Chapel Hill; Department of Medicine (S.P.J.), Beth Israel Deaconess Medical Center; Department of Surgery (C.W.H.), Johns Hopkins University School of Medicine; National Institute of Neurological Disorders and Stroke (R.F.G.); Department of Biostatistics (A.L.S.), Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine; and Penn Injury Science Center (A.L.S.), University of Pennsylvania.ORCID 0000-0001-6240-5044
Priya PaltaFrom the Department of Exercise Science (K.J.H.), Thomas Jefferson University; Department of Neurology (C.A.L., A.E.W., A.L.S.), University of Pennsylvania Perelman School of Medicine; Department of Neurology (H.E.), Hospital of the University of Pennsylvania; Memory Impairment and Neurodegenerative Dementia (MIND) Center (B.G.W.), University of Mississippi Medical Center; Department of Neurology (P.P.), University of North Carolina Chapel Hill; Department of Medicine (S.P.J.), Beth Israel Deaconess Medical Center; Department of Surgery (C.W.H.), Johns Hopkins University School of Medicine; National Institute of Neurological Disorders and Stroke (R.F.G.); Department of Biostatistics (A.L.S.), Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine; and Penn Injury Science Center (A.L.S.), University of Pennsylvania.ORCID 0009-0006-7153-5100
Stephen P JuraschekFrom the Department of Exercise Science (K.J.H.), Thomas Jefferson University; Department of Neurology (C.A.L., A.E.W., A.L.S.), University of Pennsylvania Perelman School of Medicine; Department of Neurology (H.E.), Hospital of the University of Pennsylvania; Memory Impairment and Neurodegenerative Dementia (MIND) Center (B.G.W.), University of Mississippi Medical Center; Department of Neurology (P.P.), University of North Carolina Chapel Hill; Department of Medicine (S.P.J.), Beth Israel Deaconess Medical Center; Department of Surgery (C.W.H.), Johns Hopkins University School of Medicine; National Institute of Neurological Disorders and Stroke (R.F.G.); Department of Biostatistics (A.L.S.), Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine; and Penn Injury Science Center (A.L.S.), University of Pennsylvania.ORCID 0000-0003-4168-2696
Caitlin W HicksFrom the Department of Exercise Science (K.J.H.), Thomas Jefferson University; Department of Neurology (C.A.L., A.E.W., A.L.S.), University of Pennsylvania Perelman School of Medicine; Department of Neurology (H.E.), Hospital of the University of Pennsylvania; Memory Impairment and Neurodegenerative Dementia (MIND) Center (B.G.W.), University of Mississippi Medical Center; Department of Neurology (P.P.), University of North Carolina Chapel Hill; Department of Medicine (S.P.J.), Beth Israel Deaconess Medical Center; Department of Surgery (C.W.H.), Johns Hopkins University School of Medicine; National Institute of Neurological Disorders and Stroke (R.F.G.); Department of Biostatistics (A.L.S.), Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine; and Penn Injury Science Center (A.L.S.), University of Pennsylvania.ORCID 0000-0001-7638-1936
Rebecca F GottesmanFrom the Department of Exercise Science (K.J.H.), Thomas Jefferson University; Department of Neurology (C.A.L., A.E.W., A.L.S.), University of Pennsylvania Perelman School of Medicine; Department of Neurology (H.E.), Hospital of the University of Pennsylvania; Memory Impairment and Neurodegenerative Dementia (MIND) Center (B.G.W.), University of Mississippi Medical Center; Department of Neurology (P.P.), University of North Carolina Chapel Hill; Department of Medicine (S.P.J.), Beth Israel Deaconess Medical Center; Department of Surgery (C.W.H.), Johns Hopkins University School of Medicine; National Institute of Neurological Disorders and Stroke (R.F.G.); Department of Biostatistics (A.L.S.), Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine; and Penn Injury Science Center (A.L.S.), University of Pennsylvania.ORCID 0000-0002-9504-1256
Andrea L C SchneiderFrom the Department of Exercise Science (K.J.H.), Thomas Jefferson University; Department of Neurology (C.A.L., A.E.W., A.L.S.), University of Pennsylvania Perelman School of Medicine; Department of Neurology (H.E.), Hospital of the University of Pennsylvania; Memory Impairment and Neurodegenerative Dementia (MIND) Center (B.G.W.), University of Mississippi Medical Center; Department of Neurology (P.P.), University of North Carolina Chapel Hill; Department of Medicine (S.P.J.), Beth Israel Deaconess Medical Center; Department of Surgery (C.W.H.), Johns Hopkins University School of Medicine; National Institute of Neurological Disorders and Stroke (R.F.G.); Department of Biostatistics (A.L.S.), Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine; and Penn Injury Science Center (A.L.S.), University of Pennsylvania.ORCID 0000-0003-0026-5052
University of North Carolina at Chapel Hill · US

Funding

ARIC Neurocognitive Study (ARIC-NCS) Renewal 2023-2028U01HL096812 · NHLBI · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI JOSEF CORESH, THOMAS H MOSLEY · 2010 to 2026
$65.7M
ARIC Neurocognitive Study (ARIC-NCS) Renewal 2 of 5U01HL096917 · NHLBI · UNIVERSITY OF MISSISSIPPI MED CTR · PI MOSLEY, THOMAS H · 2010 to 2018
$11.9M
ARIC Neurocognitive Study (ARIC-NCS) Renewal UNC 4 of 5U01HL096899 · NHLBI · UNIV OF NORTH CAROLINA CHAPEL HILL · PI COUPER, DAVID J · 2010 to 2018
$7.5M
ARIC Neurocognitive Study (ARIC-NCS)U01HL096902 · NHLBI · UNIVERSITY OF MINNESOTA · PI LUTSEY, PAMELA L. · 2010 to 2018
$7.4M
Prognostic Implications of Home-Based Blood Pressure Monitoring in Older AdultsR01HL158622 · NHLBI · BETH ISRAEL DEACONESS MEDICAL CENTER · PI JURASCHEK, STEPHEN P · 2021 to 2025
$4.5M
Clinical Implications of Blood Pressure Patterns Among Older AdultsR01HL153191 · NHLBI · BETH ISRAEL DEACONESS MEDICAL CENTER · PI JURASCHEK, STEPHEN P · 2021 to 2023
$2.3M
Risk Factors and Outcomes Associated with Late-Life Diabetic Peripheral NeuropathyK23DK124515 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI HICKS, CAITLIN WHITNEY · 2020 to 2024
$898k
NHLBI NIH HHS R01 HL153191NHLBI NIH HHS R01 HL158622NHLBI NIH HHS U01 HL096812NHLBI NIH HHS U01 HL096899NHLBI NIH HHS U01 HL096902NHLBI NIH HHS U01 HL096917NIDDK NIH HHS K23 DK124515
6 · The paper itself

Abstract

BACKGROUND AND

objectivesFalls are a leading cause of head injury among older adults, but the risk of fall occurring after a head injury is less well-characterized. We sought to examine the association between head injury and subsequent risk of falls requiring hospital care among community-dwelling older adults.

methodsThis analysis included 13,081 participants in the Atherosclerosis Risk in Communities Study enrolled in 1987-1989 and followed through 2019. The association of head injury (time-varying exposure, self-reported and/or ICD-9/10 code identified) with the risk of subsequent (occurring >1-month after head injury) falls requiring hospital care (ICD-9/10 code defined) was modeled using Cox proportional hazards regression. Secondary analyses included Fine and Gray proportional hazards regression to account for the competing risk of death, analysis of head injury frequency and severity, and formal testing for interaction by age, sex, and race. Models were adjusted for age, sex, race/center, education, military service, alcohol consumption, smoking, diabetes, hypertension, and psychotropic medication use.

resultsThe mean age of participants at baseline was 54 years, 58% were female, 28% were Black, and 14% had at least one head injury occurring over the study period. Over a median 23 years of follow-up, 29% of participants had a fall requiring medical care. In adjusted Cox proportional hazards models, individuals with head injury had 2.01 (95% CI 1.85-2.18) times the risk of falls compared with individuals without head injury. Accounting for the competing risk of mortality, individuals with head injury had 1.69 (95% CI 1.57-1.82) times the risk of falls compared with individuals without head injury. We observed stronger associations among men compared with women (men: hazard ratio [HR] = 2.60, 95% CI 2.25-3.00; women: HR = 1.80, 95% CI 1.63-1.99, DISCUSSION: Among community-dwelling older adults followed over 30 years, head injury was associated with subsequent falls requiring medical care. We observed stronger associations among men and with increasing number and severity of head injuries. Whether older individuals with head injury might benefit from fall prevention measures should be a focus of future research.

Indexed as

AtherosclerosisCraniocerebral TraumaDiabetes MellitusAccidental FallsAgedFemaleHumansMaleMiddle AgedRisk Factors

Identifiers

PMID37816634
PMCPMC10727209
OpenAlexW4387485647

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.