TY  - JOUR
PY  - 2017//
TI  - Remote traumatic brain injury is associated with motor dysfunction in older military veterans
JO  - Journals of gerontology. Series A: Biological sciences and medical sciences
A1  - Gardner, Raquel C.
A1  - Peltz, Carrie B.
A1  - Kenney, Kimbra
A1  - Covinsky, Kenneth E.
A1  - Diaz-Arrastia, Ramon
A1  - Yaffe, Kristine
SP  - 1233
EP  - 1238
VL  - 72
IS  - 9
N2  - 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. <br><br>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. <br><br>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. <br><br>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.<p />  <p>Language: en</p>
LA  - en
SN  - 1079-5006
UR  - http://dx.doi.org/10.1093/gerona/glw341
ID  - ref1
ER  -