Objective: Evaluate the association between traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD) among US Veterans with subsequent development of Dementia with Lewy Bodies (DLB).

Background: DLB shares a pathological hallmark with PD, but the symptomatology and rate of progression can vary dramatically. TBI and PTSD have been shown to be associated with later development of PD (Scott et al.). However, their association with potential development of DLB has not been examined. Prior observational studies examining DLB either rely on very small, well-curated cohorts susceptible to recall bias or larger single-ICD definitions with false-positive rates potentially exceeding 70% (PMID: 31645200). Understanding this association could clarify shared or divergent pathophysiological mechanisms

Method: A retrospective case-control study was performed using electronic health record data from the VA Corporate Data Warehouse under IRB approval (MIRB 04744) using a waiver of participant consent. Ascertainment of DLB was iteratively performed to achieve a positive predictive value (PPV) of 79%. Ten control subjects were chosen for each DLB case by randomized selection and matching by sex, ethnicity, race, smoking status, and birth year. Controls were also selected for those with at least the same number of years of historic medical records before the index date as their matched case. The TBI and PTSD exposures were defined by their relevant ICD codes, as done previously. Association of each disorder with DLB was calculated using conditional logistic regression adjusted for race, sex, smoking status, ethnicity, and birth year

Results: A total of 3,149 patients fulfilled the DLB case definition and 33,846 controls were identified. Veterans were mostly male and aged > 60 years. The association of TBI with DLB was significant starting 11 years before DLB diagnosis (OR 2.57, 95%CI: 2.21-2.98). The same was true for PTSD (OR 1.99, 95%CI: 1.80-2.21).

Conclusion: These data expand the known long-term risks of military trauma. Further study is needed to understand causality and whether interventions can attenuate this risk.

References: Scott GD, Neilson LE, Woltjer R, Quinn JF, Lim MM. Lifelong Association of Disorders Related to Military Trauma with Subsequent Parkinson’s Disease. Mov Disord. 2023 Aug;38(8):1483-1492. doi:10.1002/mds.29457. Epub 2023 Jun 13. PMID: 37309872.

« Back to 2025 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/elevated-risk-of-dementia-with-lewy-bodies-subsequent-to-military-trauma/