Pre-existing hyperlipidaemia increased the risk of new-onset anxiety disorders after traumatic brain injury: a 14-year population-based study

Abstract

ObjectivesAnxiety disorders (ADs) are common after traumatic brain injury (TBI). However, the risk factors of new-onset ADs remain unclear. This study was aimed at evaluating the incidence and risk factors for new-onset ADs, including pre-existing hyperlipidaemia and three major comorbidities (diabetes mellitus, hypertension and cardiovascular disease), in patients with TBI.SettingA matched cohort study was conducted using the Taiwan Longitudinal Health Insurance Database between January 1997 and December 2010.ParticipantsA total of 3822 participants (1274 patients with TBI with hyperlipidaemia and 2548 age-matched and gender-matched patients with TBI without hyperlipidaemia).Outcome measuresThe incidence and HRs for the development of new-onset ADs after TBI were compared between the two groups.ResultsThe overall incidence rate of new-onset ADs for patients with TBI with hyperlipidaemia is 142.03/10 000 person-years (PYs). Patients with TBI with hyperlipidaemia have a 1.60-fold incidence rate ratio (p<0.0001) and increased HR of ADs (1.58, 95% CI 1.24 to 2.02) compared with those without hyperlipidaemia. The incidence rates of ADs for males and females with hyperlipidaemia, respectively, were 142.12 and 292.32/10 000 PYs, which were higher than those without hyperlipidaemia (93.03 and 171.68/10 000 PYs, respectively). Stratified by age group, hyperlipidaemia is a risk factor of ADs for patients with TBI aged 65 years or younger.ConclusionsPre-existing hyperlipidaemia is an independent predictor of new-onset ADs in patients with TBI, even when controlling for other demographic and clinical variables. Female patients with pre-existing hyperlipidaemia had significantly higher risk of new-onset ADs than males, especially between the ages of 35 and 65 years.

Geriatric Traumatic Brain Injury: Epidemiology, Outcomes, Knowledge Gaps, and Future Directions

“…47 Those with one pre-existing condition often had additional co-occurring conditions, such as diabetes, cardiovascular disease, pulmonary disease, or renal disease. 65,66 Pre-injury cardiovascular conditions and endocrine disorders are particularly common in the oldest age categories of adults with moderate-severe TBI, with the presence of these conditions occurring up to 5 times more frequently among those >75 years of age compared to those ages 50-54 years. 65 Pre-existing conditions, including past history of TBI, are risk factors for sustaining a TBI.…”

Associations of Preexisting Vascular Risk Factors With Outcomes After Traumatic Brain Injury: A TRACK-TBI Study

“…Several prior animal24,25 and human9,26–30 studies have investigated associations of individual vascular risk factors with TBI outcomes, but to our knowledge, none have investigated the burden of cumulative vascular risk factors, although one study evaluated associations with a “comorbidity cluster,” which included several vascular risk factors 31. Results of these prior studies are mixed, with some studies reporting significant associations of hypertension,29,30 diabetes,28–30 and hyperlipidemia26 with TBI outcomes. Other studies reported no association of hypertension,9,31 diabetes,31 hyperlipidemia,31 or smoking27 with TBI outcomes.…”

Metabolic Profile and Long-Term Risk of Depression, Anxiety, and Stress-Related Disorders

“…The heterogeneity of previous findings may partly result from methodologic shortcomings (eg, short follow-up and small sample size). Furthermore, most of the studies investigated older individuals, with only a few exploring younger individuals . Depression was mostly ascertained using self-reported scales in previous studies, which are likely more prone to misclassification than structured clinical interviews .…”