Epidemiology of Comorbid Conditions among Adults 50 Years and Older with Traumatic Brain Injury

Raj G. Kumar, Shannon B. Juengst, Zhensheng Wang, Kristen Dams-OʼConnor, Sureyya S. Dikmen, Therese M. OʼNeil-Pirozzi, Marie N. Dahdah, Flora M. Hammond, Elizabeth R. Felix, Patricia M. Arenth, Amy K. Wagner

Research output: Contribution to journalArticlepeer-review

39 Scopus citations


Objectives: Aging individuals with traumatic brain injury (TBI) experience multiple comorbidities that can affect recovery from injury. The objective of this study was to describe the most commonly co-occurring comorbid conditions among adults 50 years and older with TBI. Setting: Level I Trauma centers. Participants: Adults 50 years and older with moderate/severe TBI enrolled in the TBI-Model Systems (TBI-MS) from 2007 to 2014 (n = 2134). Design: A TBI-MS prospective cohort study. Main Measures: International Classification of Disease-9th Revision codes collapsed into 45 comorbidity categories. Comorbidity prevalence estimates and trend analyses were conducted by age strata (50-54, 55-64, 65-74, 75-84, ≥85 years). A dimension reduction method, Treelet Transform, classified clusters of comorbidities that tended to co-occur. Results: The 3 most commonly occurring comorbid categories were hypertensive disease (52.6/100 persons), other diseases of the respiratory system (51.8/100 persons), and fluid component imbalances (43.7/100 persons). Treelet Transform classified 3 clusters of comorbid codes, broadly classified as (1) acute medical diseases/infections, (2) chronic conditions, and (3) substance abuse disorders. Conclusion: This study provides valuable insight into comorbid conditions that co-occur among adults 50 years and older with TBI and provides a foundation for future studies to explore how specific comorbidities affect TBI recovery.

Original languageEnglish (US)
Pages (from-to)15-24
Number of pages10
JournalJournal of Head Trauma Rehabilitation
Issue number1
StatePublished - 2018


  • aging
  • brain injuries
  • comorbidity
  • epidemiology

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation
  • Clinical Neurology


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