Editors' Note: Sex, Race, and Risk of Dementia Diagnosis After Traumatic Brain Injury Among Older Veterans

Traumatic brain injury (TBI) has a well-known association with cognitive impairment and dementia. Whether there is a differential risk of dementia after TBI based on sex, race, or ethnicity was the subject of the recently published retrospective cohort study by Dr. Kornblith et al. Using a 2% random sample of claims data from Veterans Health Administration systems databases (n = 999,640), investigators evaluated the cumulative incidence of all-cause dementia by age, sex, race, and ethnicity. They found a significant interaction between TBI and race for dementia, in which White veterans were at the highest risk for dementia diagnoses. Dr. Roberts affirms these findings are consistent with the literature on White vs Black NFL players, in which White athletes are diagnosed more frequently with postconcussion “dementia” and receive greater compensation for this disability. More importantly, Dr. Roberts emphasizes that this racial discrepancy in dementia diagnoses is not likely an indicator of differential disease burden between races but is more reflective of racial care inequality. Dr. Kornblith agrees that racial disparities in health care are ubiquitous and demand more than just our attention. They demand action.

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