Citation

Gardner RC, Peltz CB, Kenney K, Covinsky KE, Diaz-Arrastia R, Yaffe K. J. Gerontol. A Biol. Sci. Med. Sci. 2017; 72(9): 1233-1238.

Affiliation

Department of Epidemiology and Biostatistics, University of California San Francisco.

Copyright

(Copyright © 2017, Gerontological Society of America)

DOI

10.1093/gerona/glw341

PMID

28329183

Abstract

BACKGROUND: Traumatic brain injury (TBI) has been identified as a risk factor for Parkinson's disease (PD). Motor dysfunction among TBI-exposed elders without PD has not been well characterized. We sought to determine whether remote TBI is a risk factor for motor dysfunction on exam and functionally relevant motor dysfunction in day-to-day life among independently living elders without PD.

METHODS: This is a cross-sectional cohort study of independently living retired military veterans aged 50 or older with (n = 78) and without (n = 85) prior TBI-all without diagnosed PD. To characterize multidimensional aspects of motor function on exam, the Unified Parkinson's Disease Rating Scale (UPDRS) Motor Examination was performed by a board-certified neurologist and used to calculate a modified UPDRS (mUPDRS) global motor score and four domain scores (tremor, rigidity, bradykinesia, and posture/gait). Functionally relevant motor dysfunction was assessed via self-report of falls within the past year.

RESULTS: In analyses adjusted for demographics and comorbidities that differed between groups, compared with veterans without TBI, those with moderate-to-severe TBI were more likely to have fallen in past year (33% vs. 14%, risk ratio 2.5 [95% confidence interval 1.1-5.4]), had higher (worse) mUPDRS global motor (p =.03) and posture/gait scores (p =.02), but not higher tremor (p =.70), rigidity (p =.21), or bradykinesia scores (p =.22). Mild TBI was not associated with worse motor function.

CONCLUSIONS: Remote moderate-to-severe TBI is a risk factor for motor dysfunction-defined as recent falls and impaired posture/gait-among older veterans. TBI-exposed older adults may be ideal candidates for aggressive fall-screening and prevention strategies.

Language: en

Keywords

Falls; Parkinson’s disease; Risk factors