AI Article Synopsis
- Middle-aged and older adults with traumatic spinal cord injury (TSCI) face an increased risk of developing Alzheimer disease and related dementia (ADRD) compared to their peers without TSCI.
- A cohort study using claims data from 2007-2017 found that incidence rates of ADRD were significantly higher in individuals with TSCI, with hazard ratios indicating a greater risk especially in the younger age group (45-64 years).
- The findings highlight the need for enhanced cognitive screening and early intervention strategies for adults living with TSCI to help preserve their cognitive health.
Article Abstract
Objective: Traumatic spinal cord injury (TSCI) is a life altering event most often causing permanent physical disability. Little is known about the risk of developing Alzheimer disease and related dementia (ADRD) among middle-aged and older adults living with TSCI. Time to diagnosis of and adjusted hazard for ADRD was assessed.
Design: Cohort study.
Setting: Using 2007-2017 claims data from the Optum Clinformatics Data Mart, we identified adults (45+) with diagnosis of TSCI (n=7019). Adults without TSCI diagnosis were included as comparators (n=916,516). Using age, sex, race/ethnicity, cardiometabolic, psychological, and musculoskeletal chronic conditions, US Census division, and socioeconomic variables, we propensity score matched persons with and without TSCI (n=6083). Incidence estimates of ADRD were compared at 4 years of enrollment. Survival models were used to quantify unadjusted, fully adjusted, and propensity-matched unadjusted and adjusted hazard ratios (HRs) for incident ADRD.
Participants: Adults with and without TSCI (N=6083).
Intervention: Not applicable.
Main Outcomes Measures: Diagnosis of ADRD.
Results: Both middle-aged and older adults with TSCI had higher incident ADRD compared to those without TSCI (0.5% vs 0.2% and 11.7% vs 3.3% among 45-64 and 65+ y old unmatched cohorts, respectively) (0.5% vs 0.3% and 10.6% vs 6.2% among 45-64 and 65+ y old matched cohorts, respectively). Fully adjusted survival models indicated that adults with TSCI had a greater hazard for ADRD (among 45-64y old: unmatched HR: 3.19 [95% confidence interval, 95% CI, 2.30-4.44], matched HR: 1.93 [95% CI, 1.06-3.51]; among 65+ years old: unmatched HR: 1.90 [95% CI, 1.77-2.04], matched HR: 1.77 [1.55-2.02]).
Conclusions: Adults with TSCI are at a heightened risk for ADRD. Improved clinical screening and early interventions aiming to preserve cognitive function are of paramount importance for this patient cohort.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10536758 | PMC |
| http://dx.doi.org/10.1016/j.apmr.2020.12.019 | DOI Listing |
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