Sex, Race, and Risk of Dementia after Traumatic Brain Injury among Older Veterans

Objective: To investigate whether sex and race differences exist in dementia risk associated with TBI among older Veterans.

Materials and Methods:  Using Fine-Gray regression models, we investigated incident dementia risk with TBI exposure by sex and race.

Results: After excluding baseline prevalent dementia, the final sample (all Veterans 55+ diagnosed with TBI during the 2001-2015 study period and a random sample of all Veterans receiving Veterans Health Administration care) included nearly one million Veterans (4.3% female and 81.8% White, 11.5% Black and 1.25% Hispanic), 96,178 with TBI and 903,462 without TBI.  Of those with TBI 11.5% developed dementia compared to 5.8% without TBI, p<0.001.  Compared to those without TBI, Hispanic Veterans with TBI were almost two times more likely (17.0% vs. 10.3%; HR: 1.74, 95% CI: 1.51-2.01), Black Veterans with TBI were over two times more likely (11.2% vs. 6.4%; HR=2.15, 95% CI: 2.02-2.30), and White Veterans with TBI were nearly thr...