Association of remote traumatic brain injury and military employment with late-life trajectories of depressive symptom severity

JOURNAL OF AFFECTIVE DISORDERS

卷:281

Article

Kumar, Raj G.¹  Jayasinghe, Nimali^1,3  Walker, Rod L.⁶  Gibbons, Laura E.⁵  Power, Melinda C.⁴  Larson, Eric B.^5,6  Crane, Paul K.⁵  Connor, Kristen Dams-O^1,2 

[1] Icahn Sch Med Mt Sinai, Dept Rehabil & Human Performance, New York, NY 10029 USA

[2] Icahn Sch Med Mt Sinai, Dept Neurol, New York, NY 10029 USA

[3] Weill Cornell Med, Dept Psychiat, New York, NY USA

[4] George Washington Univ, Dept Epidemiol, Milken Inst, Sch Publ Hlth, Washington, DC 20052 USA

[5] Univ Washington, Seattle, WA 98195 USA

[6] Kaiser Permanente Washington Hlth Res Inst, Seattle, WA USA

关键词: Traumatic Brain Injury;    Military veteran health;    Depression;    Geriatrics;   

DOI  :  10.1016/j.jad.2020.12.003

来源: Elsevier

【 摘 要 】

Background: Traumatic brain injury (TBI) and military service are common lifetime exposures among current older adults that may affect late-life mental health. The objective of the present study was to evaluate the association between TBI with loss of consciousness (LOC) and military employment and late-life depressive symptom severity trajectory. Methods: 1445 males and 2096 females adults at least 65 years old without dementia or recent TBI were enrolled and followed biennially for up to 10 years in the Adult Changes in Thought study from Kaiser Permanente Washington in Seattle, Washington. Results: Using group-based trajectory modeling, we documented four distinct depressive symptom severity trajectories that followed a similar course in males and females (Minimal, Decreasing, Increasing, and Persistent). In multinomial regression analyses, TBI with LOC in males was associated with greater likelihood of Persistent versus Minimal depressive symptom severity compared to individuals without TBI (OR = 1.51, 95% CI: 1.01, 2.27; p=0.046). Males reporting past military employment had greater likelihood of Decreasing versus Minimal depressive symptom severity compared to individuals without past military employment (OR = 1.54, 95% CI: 1.03, 2.31; p=0.035). There was no association between TBI or military employment and depression trajectories in females, and no evidence of effect modification by age or between exposures. Limitations: Lifetime history of TBI was ascertained retrospectively and may be subject to recall bias. Also, past military employment does not presuppose combat exposure. Conclusions: Remote TBI and past military employment are relevant to late-life trajectories of depressive symptom severity in dementia-free older males.

【 授权许可】

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