Prevalence of Lifetime History of Traumatic Brain Injury among Older Male Veterans Compared to Civilians: A Nationally Representative Study

Traumatic brain injury (TBI) is common among older adults as well as among Veterans in the United States and can increase risk for dementia. We compared prevalence of TBI in older male Veterans and civilians using a nationally representative sample. We examined data from 599 male respondents to the 2014 Wave of the Health and Retirement Study (HRS), a nationally representative survey of older adults, randomly selected to participate in a comprehensive TBI survey. Respondents self-reported no injury, non-TBI head/neck injury (NTI), or TBI. We used weighted analyses to examine prevalence of injury and relative risk of injury sub-types. Among male Veterans, we found a national prevalence of over 70% for lifetime history of any head/neck injury (TBI plus NTI), 14.3% for multiple NTI, and 36% for lifetime history of at least one TBI. In contrast, prevalence estimates for male civilians were 58% for lifetime history of head/neck injury, 4.8% for multiple NTI, and 45% for lifetime history of at least one TBI (all comparisons p<0.001). Male civilians have higher self-reported TBI prevalence, while male Veterans have higher self-reported NTI and multiple-NTI prevalence. Further research on drivers of the unexpectedly higher prevalence of lifetime history of TBI in male civilians, as well as on mechanisms and sequelae of the highly prevalent non-TBI head/neck injuries among older male Veterans, is warranted.Traumatic brain injury (TBI) is common among older adults as well as among Veterans in the United States and can increase risk for dementia. We compared prevalence of TBI in older male Veterans and civilians using a nationally representative sample. We examined data from 599 male respondents to the 2014 Wave of the Health and Retirement Study (HRS), a nationally representative survey of older adults, randomly selected to participate in a comprehensive TBI survey. Respondents self-reported no injury, non-TBI head/neck injury (NTI), or TBI. We used weighted analyses to examine prevalence of injury and relative risk of injury sub-types. Among male Veterans, we found a national prevalence of over 70% for lifetime history of any head/neck injury (TBI plus NTI), 14.3% for multiple NTI, and 36% for lifetime history of at least one TBI. In contrast, prevalence estimates for male civilians were 58% for lifetime history of head/neck injury, 4.8% for multiple NTI, and 45% for lifetime history of at least one TBI (all comparisons p<0.001). Male civilians have higher self-reported TBI prevalence, while male Veterans have higher self-reported NTI and multiple-NTI prevalence. Further research on drivers of the unexpectedly higher prevalence of lifetime history of TBI in male civilians, as well as on mechanisms and sequelae of the highly prevalent non-TBI head/neck injuries among older male Veterans, is warranted.