Rate of incident dementia and care needs among older adults with new traumatic brain injury: a population-based cohort study
Bibliographic record
Abstract
BACKGROUND: The long-term impacts of traumatic brain injury (TBI) in older adults are not well known. Our objective was to describe the association between late-life TBI, incident dementia, and health care needs. METHODS: We conducted a retrospective cohort study using linked health administrative data in Ontario, Canada, and included community-dwelling individuals older than 65 years with a new TBI between Apr. 1, 2004, and Mar. 1, 2020, and up to 17 years of follow-up. People with and without TBI were 1:1 matched on age, sex, and propensity score. We compared rates of incident dementia (≤ 5 yr and > 5 yr), use of publicly funded home care, and admission to a long-term care home, using cause-specific hazard models. We used conditional inference trees to identify subgroups at high risk for outcomes based on associations with individual and intersecting social determinants of health. RESULTS: We included 132 113 matched pairs. Late-life TBI was associated with an increased rate of incident dementia (≤ 5 yr: hazard ratio [HR] 1.69, 95% confidence interval [CI] 1.66 to 1.72; > 5 yr: HR 1.56, 95% CI 1.53 to 1.59), use of publicly funded home care (HR 1.30, 95% CI 1.29 to 1.31), and admission to a long-term care home (HR 1.45, 95% CI 1.42 to 1.47). Dementia was more common among older females from low-income neighbourhoods than among male peers (29.0% v. 24.7%). Residents of smaller communities received less home care than those in larger communities (60.1% v. 64.6%) and had a higher probability of long-term care home admission (26.3% v. 21.7%). INTERPRETATION: Late-life TBI in community-dwelling older adults is associated with higher rates of incident dementia, use of publicly funded home care, and admission to a long-term care home, with older females and residents of smaller communities experiencing poorer outcomes. Clinical awareness and policy planning that reflects these needs and population heterogeneity are important. PROTOCOL REGISTRATION: Open Science Framework identifier 10.17605/OSF.IO/KZT3F.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".