Genetics, Comorbidities, and Ethnicity: Effects of TBI on Dementia
Abstract
An estimated 10% to 20% of Veterans from the wars in Iraq and Afghanistan have suffered traumatic brain injury (TBI). Many Veterans from prior conflicts have experienced TBI as well. Some studies have reported a link between TBI and increased risk of cognitive impairment and dementia even after years of active life post-injury but few have studied Veterans. In addition, TBI has been linked with poor socioeconomic, medical, and psychiatric outcomes. These outcomes have also been identified as independent risk factors for worse cognitive outcomes, including dementia, but we do not know how such factors may increase or decrease the risk of dementia after TBI. Furthermore, no study has examined how race and ethnicity may influence TBI outcomes and risk of dementia even though in recent decades, the country and U.S. military have become more racially and ethnically diverse. Understanding the relationship of race/ethnicity, socioeconomic status, medical and psychiatric comorbidities with TBI and risk of dementia could inform clinical care and prevention for Veterans with TBI. We propose a new research partnership to study two large datasets of Veterans: one dataset of 1.6 million Veterans including around 260,000 with TBI and another dataset of approximately 3,000 twin pairs. Our overall hypothesis is that Veterans who are non-white, have lower income and education, and those with more medical and psychiatric diagnoses will have a higher risk of dementia after TBI. Further, we hypothesize that these differences will still be present after accounting for early life effects and genetics by studying twin pairs. To help understand the public health impact of TBI, we also seek to understand what proportion of dementia cases might be explained by TBI and how this may differ among Veterans and non-Veterans. In this new and exciting collaboration, our focus will be on factors that have been reported to be both a consequence of TBI and to influence risk of cognitive outcomes in older adulthood. We aim to examine these complex relationships and determine which factors are modifiable and have the most influence on later outcomes among TBI survivors. The modifiable factors can then be targeted for policy changes or interventions to prevent dementia after TBI.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Oct 29, 2018
- Source ID
- W81XWH1810692
Entities
People
- Kristine Yaffe
Organizations
- Northern California Institute for Research and Education
- United States Army