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Social determinants of health are associated with traumatic brain injury (TBI) incidence among older adults, according to a study published online May 31 in JAMA Network Open.

Erica Kornblith, Ph.D., from the University of California in San Francisco, and colleagues conducted a nationally representative longitudinal cohort study involving participants aged 65 years and older who were assessed for 18 years using data from the Health and Retirement Study and linked Medicare claims to examine how social determinants of health are associated with TBI incidence. Of the 9,239 eligible respondents, 9.1, 4.7, and 84.4 percent were Black, Hispanic, and White, respectively.

The researchers found that respondents with TBI were more likely to be female and White (absolute differences, 7.0 and 5.1, respectively), have normal cognition versus cognitive impairment or dementia (absolute difference, 6.1), have higher education and wealth (absolute differences, 3.8 and 6.5, respectively), and be without baseline lung disease or functional impairment (absolute differences, 5.1 and 3.3, respectively) compared with those without TBI. Lower education, Black race, area deprivation index national rank, and male sex were significantly associated with being in the group without TBI in adjusted multivariable models. Similar results were obtained with a sensitivity analysis using a broader definition of TBI.

“It’s possible that our findings reflect that adults who are healthier, wealthier and more active are more able or likely to engage in activities that carry risk for TBI,” Kornblith said in a statement.

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