Grant: Travel Awards - Institute Community Support

Background: Every year, one in five Canadian older adults (aged 65 years or above) experiences falls, which can lead to a traumatic brain injury (TBI). While older adults with TBI may have a higher rate of dementia, we do not know the magnitude of this association. We also need information about services to address their care needs, including community or long-term care support, and to understand how social determinants of health may impact health opportunities and outcomes. Methods: We conducted a population-level study using health administrative data from Ontario, Canada, including over 130,000 community-dwelling older adults aged 66 years and older who experienced a TBI between 2004 and 2020. Each individual with a TBI was matched 1:1 to a similar individual without a TBI based on age, sex, and health characteristics. We compared the two groups to determine the rate of dementia, home care use, and long-term care home admission. We also explored how social determinants of health, like income, community size, and age, influenced these outcomes. Results: We found that older adults with TBI were associated with a higher rate of developing dementia, using home care services, and being admitted to a long-term care home compared to those without TBI. Women aged 75 and older from lower-income neighbourhoods were at the highest risk of dementia. People in urban areas were more likely to receive home care, while those in rural, lower-income, and less ethnically diverse areas were more likely to be admitted to long-term care homes. Conclusions: Older adults with TBI are at a higher risk of dementia and increased healthcare use, including home care and long-term care home admission. Social determinants of health, such as income, age, and location, play an essential role in these outcomes. Understanding these pathways can help develop targeted strategies to improve care and outcomes for at-risk older adults.