ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2025
Rate of incident dementia and care needs among older adults with new traumatic brain injury: a population-based cohort study.
Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Delirium in Patients With Traumatic Brain Injury and Long-Term Cognitive Decline: A Global Federated Real World Data Analysis.European journal of clinical investigation · 2026Article
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11 authors.
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Abstract
backgroundThe long-term impacts of traumatic brain injury (TBI) in older adults are not well known. Our objective was to describe the association between late-life TBI, incident dementia, and health care needs.
methodsWe conducted a retrospective cohort study using linked health administrative data in Ontario, Canada, and included community-dwelling individuals older than 65 years with a new TBI between Apr. 1, 2004, and Mar. 1, 2020, and up to 17 years of follow-up. People with and without TBI were 1:1 matched on age, sex, and propensity score. We compared rates of incident dementia (≤ 5 yr and > 5 yr), use of publicly funded home care, and admission to a long-term care home, using cause-specific hazard models. We used conditional inference trees to identify subgroups at high risk for outcomes based on associations with individual and intersecting social determinants of health.
resultsWe included 132 113 matched pairs. Late-life TBI was associated with an increased rate of incident dementia (≤ 5 yr: hazard ratio [HR] 1.69, 95% confidence interval [CI] 1.66 to 1.72; > 5 yr: HR 1.56, 95% CI 1.53 to 1.59), use of publicly funded home care (HR 1.30, 95% CI 1.29 to 1.31), and admission to a long-term care home (HR 1.45, 95% CI 1.42 to 1.47). Dementia was more common among older females from low-income neighbourhoods than among male peers (29.0% v. 24.7%). Residents of smaller communities received less home care than those in larger communities (60.1% v. 64.6%) and had a higher probability of long-term care home admission (26.3% v. 21.7%).
interpretationLate-life TBI in community-dwelling older adults is associated with higher rates of incident dementia, use of publicly funded home care, and admission to a long-term care home, with older females and residents of smaller communities experiencing poorer outcomes. Clinical awareness and policy planning that reflects these needs and population heterogeneity are important. PROTOCOL REGISTRATION: Open Science Framework identifier 10.17605/OSF.IO/KZT3F.
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