TY  - JOUR
PY  - 2021//
TI  - Association of lifetime TBI and military employment with late-life ADL functioning: a population-based prospective cohort study
JO  - Archives of physical medicine and rehabilitation
A1  - Tabio, Laura
A1  - Walker, Rod
A1  - Crane, Paul K.
A1  - Gibbons, Laura E.
A1  - Kumar, Raj
A1  - Power, Melinda C.
A1  - Kelley, Amy S.
A1  - Larson, Eric B.
A1  - Dams-O'connor, Kristen
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - OBJECTIVE: To determine associations of traumatic brain injury (TBI) and military employment with activities of daily living (ADL) in late life. SETTING: Community-based integrated healthcare delivery system. PARTICIPANTS: Male (n=2066) and female (n=2887), aged 65+ and dementia-free. <br><br>DESIGN: Population-based prospective cohort study with biennial follow-up and censoring at time of dementia diagnosis. MAIN OUTCOME MEASURES: ADL difficulties at baseline and accumulation during follow-up. <br><br>RESULTS: TBI with loss of consciousness (LOC) before age 40 was associated with slightly higher ADL difficulty at baseline for females (RR=1.44, 95% CI: 1.08-1.93, p=0.01). For males, TBI with LOC at any age was associated with greater ADL difficulty at baseline (age <40: RR=1.58, 95% CI: 1.20 - 2.08, p = 0.001; age 40+: RR=2.14, 95% CI: 1.24 - 3.68, p = 0.006). TBI with LOC was not associated with the rate of accumulation of ADL difficulties over time in males or females. There was no evidence of an association between military employment and either outcome, nor of an interaction between military employment and TBI with LOC. <br><br>FINDINGS were consistent across a variety of sensitivity analyses. <br><br>CONCLUSION: Further investigation into factors underlying greater late-life functional impairment among TBI survivors is warranted.<p />  <p>Language: en</p>
LA  - en
SN  - 0003-9993
UR  - http://dx.doi.org/10.1016/j.apmr.2021.06.018
ID  - ref1
ER  -