Incidence and Associated Risk Factors of Traumatic Brain Injury in a Cohort of Homeless and Vulnerably Housed Adults in 3 Canadian Cities [2017]

Objective: To examine the factors associated with incident traumatic brain injury (TBI) among homeless and vulnerably housed persons over a 3-year follow-up period.

Setting and participants: Data were obtained from the Health and Housing in Transition study, which tracked the health and housing status of 1190 homeless or vulnerably housed individuals in 3 Canadian cities for 3 years.

Design and Main Measures: Main measure was self-reported incident TBI during the follow-up period. Factors associated with TBI were ascertained using mixed-effects logistic regression.

Results: During first, second, and third years of follow-up, 187 (19.4%), 166 (17.1%), and 172 (17.9%) participants reported a minimum of 1 incident TBI, respectively. Among 825 participants with available data for all 3 years of follow-up, 307 (37.2%) reported at least 1 incident TBI during the 3-year follow-up period. Lifetime prevalence of TBI, endorsing a history of mental health diagnoses at baseline, problematic alcohol and drug use, younger age, poorer mental health, and residential instability were associated with increased risk of incident TBI during follow-up period.

Conclusion: Mental health support and addressing residential instability and problematic substance use may reduce further risk of TBI and its associated poor health and social outcomes in this population.

Nikoo, Mohammadali MD; Gadermann, Anne PhD; To, Matthew J. BMSc; Krausz, Michael MD, PhD, FRCPC; Hwang, Stephen W. MD, MPH; Palepu, Anita MD, MPH, FRCPC, MACP

Journal of Head Trauma Rehabilitation, July/August 2017 – Volume 32 – Issue 4

doi: 10.1097/HTR.0000000000000262