Traumatic brain injury associated with dementia risk among people with type 1 diabetes

Paola Gilsanz, Kathleen Albers, Michal Schnaider Beeri, Andrew J. Karter, Charles P. Quesenberry, Rachel Whitmer

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

RESULTS: A total of 178 individuals (4.4%) experienced a TBI and 212 (5.2%) developed dementia. In fully adjusted models, TBI was associated with 3.6 times the dementia risk (hazard ratio [HR] 3.64; 95% confidence interval [CI] 2.34, 5.68). When accounting for the competing risk of death, TBI was associated with almost 3 times the risk of dementia (HR 2.91; 95% CI 1.29, 5.68).

CONCLUSION: This study demonstrates a marked increase in risk of dementia associated with TBI among middle-aged and elderly people with T1D. Given the complexity of self-care for individuals with T1D, and the comorbidities that predispose them to trauma and falls, future work is needed on interventions protecting brain health in this vulnerable population, which is now living to old age.

OBJECTIVE: To examine the association between traumatic brain injury (TBI) and dementia risk among a cohort of middle-aged and elderly individuals with type 1 diabetes (T1D).

METHODS: We evaluated 4,049 members of an integrated health care system with T1D ≥50 years old between January 1, 1996, and September 30, 2015. Dementia and TBI diagnoses throughout the study period were abstracted from medical records. Cox proportional hazards models estimated associations between time-dependent TBI and dementia adjusting for demographics, HbA1c, nephropathy, neuropathy, stroke, peripheral artery disease, depression, and dysglycemic events. Fine and Gray regression models evaluated the association between baseline TBI and dementia risk accounting for competing risk of death.

Original languageEnglish (US)
Pages (from-to)e1611-e1618
JournalNeurology
Volume91
Issue number17
DOIs
StatePublished - Oct 23 2018

ASJC Scopus subject areas

  • Clinical Neurology

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    Gilsanz, P., Albers, K., Beeri, M. S., Karter, A. J., Quesenberry, C. P., & Whitmer, R. (2018). Traumatic brain injury associated with dementia risk among people with type 1 diabetes. Neurology, 91(17), e1611-e1618. https://doi.org/10.1212/WNL.0000000000006391