Risk of Parkinson's Disease after Traumatic Brain Injury versus Nonbrain Trauma (S36.002)

OBJECTIVE: To quantify risk of Parkinson’s Disease (PD) after traumatic brain injury (TBI) sustained in older-adulthood. BACKGROUND: TBI is a risk factor for PD. Risk of PD after recent TBI in older adults has proven difficult to assess due to possible confounding or reverse-causation if patients with incipient PD are more prone to injury. To mitigate this concern we compared TBI to non-TBI trauma (NTT). DESIGN/METHODS: Using administrative emergency department (ED) and inpatient data from California hospitals, we identified patients age 蠅55 with TBI (n=53,303) or NTT (n=114,269) diagnosed in 2005-2006 who didn’t have baseline PD or dementia and survived to discharge (total n=167,572). TBI was defined according to Centers for Disease Control ICD-9 criteria. NTT was defined as fracture, excluding fractures of head/neck. Using Cox proportional hazards ratios (adjusted for demographics, comorbidities, healthcare use, trauma severity), we estimated risk of PD after TBI or NTT through 12/31/2011, excluding patients with PD diagnoses made 1 TBI) were also assessed. RESULTS: TBI patients were significantly more likely to be diagnosed with PD compared to NTT patients (1.7[percnt] versus 1.1[percnt], p 1 TBI HR 1.85, 95[percnt] CI 1.56-2.18) suggested a dose-response. CONCLUSIONS: Among patients age 蠅55 presenting to an ED/inpatient setting with trauma, TBI is associated with a 45[percnt] increased risk of PD over the subsequent 5-7 years that is likely not entirely due to confounding or reverse-causation. Disclosure: Dr. Gardner has nothing to disclose. Dr. Burke has nothing to disclose. Dr. Nettiksimmons has nothing to disclose. Dr. Kaup has nothing to disclose. Dr. Barnes has received research support from Posit Science. Dr. Goldman has nothing to disclose. Dr. Tanner has received personal compensation for activities with Pfizer Inc. as a consultant. Dr. Yaffe has received personal compensation for activities with Pfizer Inc., Medivation, and Novartis.