Department of Psychiatry, University of California, San Francisco, San Francisco, California, USA.
San Francisco Veterans Affairs Medical Center, San Francisco, California, USA.
J Neurotrauma. 2020 Dec 15;37(24):2680-2685. doi: 10.1089/neu.2020.7062. Epub 2020 Aug 26.
Traumatic brain injury (TBI) is common among older adults as well as among veterans in the United States and can increase risk for dementia. We compared prevalence of TBI in older male veterans and civilians using a nationally representative sample. We examined data from 599 male respondents to the 2014 wave of the Health and Retirement Study (HRS), a nationally representative survey of older adults, randomly selected to participate in a comprehensive TBI survey. Respondents self-reported no injury, non-TBI head/neck injury (NTI), or TBI. We used weighted analyses to examine prevalence of injury and relative risk of injury subtypes. Among male veterans, we found a national prevalence of more than 70% for lifetime history of any head/neck injury (TBI plus NTI), 14.3% for multiple NTI, and 36% for lifetime history of at least one TBI. In contrast, prevalence estimates for male civilians were 58% for lifetime history of head/neck injury, 4.8% for multiple NTI, and 45% for lifetime history of at least one TBI (all comparisons, < 0.001). Male civilians have higher self-reported TBI prevalence, whereas male veterans have higher self-reported NTI and multiple-NTI prevalence. Further research on drivers of the unexpectedly higher prevalence of lifetime history of TBI in male civilians, as well as on mechanisms and sequelae of the highly prevalent non-TBI head/neck injuries among older male veterans, is warranted.
创伤性脑损伤（TBI）在美国的老年人和退伍军人中很常见，并且会增加痴呆的风险。我们使用具有全国代表性的样本比较了老年男性退伍军人和平民中 TBI 的患病率。我们研究了从 2014 年健康与退休研究（HRS）的第 599 位男性受访者的数据，HRS 是一项针对老年人的全国性调查，随机选择他们参加一项全面的 TBI 调查。受访者自我报告没有受伤、非 TBI 头/颈部受伤（NTI）或 TBI。我们使用加权分析来检查受伤的患病率和受伤亚型的相对风险。在男性退伍军人中，我们发现全国范围内有超过 70%的人有终身头部/颈部受伤史（TBI 加 NTI），14.3%的人有多次 NTI，36%的人有终身至少一次 TBI 的历史。相比之下，男性平民的终身头部/颈部受伤史的患病率估计为 58%，多次 NTI 的患病率为 4.8%，至少有一次 TBI 的患病率为 45%（所有比较， < 0.001）。男性平民的自我报告 TBI 患病率较高，而男性退伍军人的自我报告 NTI 和多次 NTI 患病率较高。有必要进一步研究男性平民中 TBI 终身史患病率异常高的原因，以及老年男性退伍军人中高度流行的非 TBI 头/颈部受伤的机制和后果。
