Traumatic Brain Injury and Early Onset Dementia in Post 9-11 Veterans.
Eamonn Kennedy, Samin Panahi, Ian J Stewart and 9 others
PMID 35125061WHAT IT FOUND
Post-9/11 Veterans with a history of traumatic brain injury had three times the odds of early-onset dementia compared to matched controls.
The risk was nearly six times higher for frontotemporal dementia than for Alzheimer's, suggesting TBI may specifically drive FTD pathology.
Key findings
01Veterans with any history of TBI had significantly higher adjusted odds of early-onset dementia compared to matched controls.
02The association between TBI and dementia was stronger for frontotemporal dementia than for Alzheimer's disease.
03TBI was the most frequently documented condition among the Veterans with early-onset dementia, surpassing epilepsy and other neurological conditions in prevalence within the case group.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study relied on administrative data and self-reported TBI history, which is subject to recall bias and underreporting, especially for mild TBIs. Genetic factors and cognitive reserve were not measured or controlled for, which could confound the relationship between TBI and dementia risk. Diagnoses of early-onset dementia were based on ICD codes without biomarker confirmation (like PET scans or CSF analysis), so some cases may have been misclassified, although the positive predictive value for FTD and AD codes was high. The study could not determine the exact mechanism of injury or the full lifetime history of TBI for all participants.
Declared interests
The study was supported by the U.S. Government (Non-P.H.S.), specifically the Department of Defense and Veterans Health Administration. No commercial conflicts of interest were reported.
The easy way to misread this
Do not interpret the high odds ratio for frontotemporal dementia as proof that TBI causes FTD exclusively. The study shows an association, but the diagnosis of FTD in these Veterans was based on clinical records without biomarker confirmation, and the symptoms of TBI and FTD can overlap, potentially leading to misclassification.