McGuire Connor, Kristman Vicki L, Martin Lynn, Bédard Michel
Department of Health Sciences, Lakehead University, Thunder Bay, ON, Canada.
Department of Health Sciences, Lakehead University, Thunder Bay, ON, Canada; Institute for Work & Health, Toronto, ON, Canada; Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Northern Ontario School of Medicine, Lakehead University, Thunder Bay, ON, Canada; Centre for Applied Health Research, St. Joseph's Care Group, Thunder Bay, ON, Canada, Canada.
Can Geriatr J. 2017 Mar 31;20(1):2-9. doi: 10.5770/cgj.20.228. eCollection 2017 Mar.
Describe the characteristics and determine the annual cumulative incidence of traumatic brain injury (TBI) in older adults receiving home care in Ontario from 2003 to 2013.
A retrospective cohort study of longitudinal data from the Ontario Association of Community Care Access Centers (N = 554,313). TBI, demographic variables, depression, neurological conditions, and recent falls were measured from the Resident Assessment Instrument-Home Care. Comparisons were made between service users with and without TBI using odds ratios. Standardized incidence rates were calculated and the 10-year trend of annual cumulative incidence rates was examined.
Characteristics associated with TBI: male sex (OR: 1.54), aboriginal origin (OR: 1.98), increasing age (low of OR: 1.22, in 70-74 years; high of OR: 2.31, in 90 years and older; comparison 65-69 years), being widowed (OR: 1.59), having one or more falls (OR: 2.31), the use of antidepressants (OR: 1.49) and the presence of depression (OR: 1.57), dementia (OR: 1.65), hemiplegia (OR: 4.34), multiple sclerosis (OR: 3.19) or parkinsonism (OR: 1.22). TBI incidence was significantly higher than rates previously reported in the literature. There was no change in the overall annual cumulative incidence over the 10-year period ( = .13).
Certain demographic characteristics, neurological diseases, antidepressant use, and a recent fall are associated with TBI. Incidence of TBI is higher than previous estimates and the overall incidence is not changing over time. These results can be used to improve care of the elderly and to generate hypotheses for future research regarding TBI in the home care setting.
描述2003年至2013年在安大略省接受家庭护理的老年人创伤性脑损伤（TBI）的特征，并确定其年度累积发病率。
对安大略省社区护理接入中心协会的纵向数据进行回顾性队列研究（N = 554,313）。通过居民评估工具-家庭护理来测量创伤性脑损伤、人口统计学变量、抑郁症、神经系统疾病和近期跌倒情况。使用比值比比较有和没有创伤性脑损伤的服务使用者。计算标准化发病率，并检查年度累积发病率的10年趋势。
与创伤性脑损伤相关的特征：男性（比值比：1.54）、原住民（比值比：1.98）、年龄增长（比值比最低为1.22，70 - 74岁；最高为2.31，90岁及以上；与65 - 69岁相比）、丧偶（比值比：1.59）、有一次或多次跌倒（比值比：2.31）、使用抗抑郁药（比值比：1.49）以及患有抑郁症（比值比：1.57）、痴呆症（比值比：1.65）、偏瘫（比值比：4.34）、多发性硬化症（比值比：3.19）或帕金森症（比值比：1.22）。创伤性脑损伤发病率显著高于先前文献报道的发病率。在这10年期间，总体年度累积发病率没有变化（P = 0.13）。
某些人口统计学特征、神经系统疾病、抗抑郁药使用和近期跌倒与创伤性脑损伤有关。创伤性脑损伤的发病率高于先前估计，且总体发病率未随时间变化。这些结果可用于改善对老年人的护理，并为家庭护理环境中创伤性脑损伤的未来研究提出假设。
