Agricultural Injuries With Dementia: Double Whammy?

Nearly 40% of US farmers are over 65 years old. Some emerging evidence links agricultural occupational exposure to increased dementia risk. However, little is known about dementia and injury outcomes in agricultural settings.

We employed data from the American College of Surgeons Trauma Quality Programs Participant Use File (ACS-TQP-PUF) (2017-2021), identifying individuals aged ≥ 60 with (1) agricultural injuries and dementia (Group 1; N = 318), (2) agricultural injuries without dementia (Group 2; N = 21,361), and (3) dementia without agricultural injuries (Group 3; N = 231,231). Injury mechanisms were compared across groups using chi-square tests. Injury severity was assessed via Injury Severity Score and the use of intensive care unit (ICU) or surgical care by hospitalized patients. Generalized ordered logit and logistic regression models estimated associations between group membership and injury severity, adjusting for demographics and comorbidities.

Falls caused 94% of traumatic injuries in individuals with dementia alone but accounted for only 35% of injuries in those with both agricultural injuries and dementia. Group 1 and Group 2 experienced a broader range of injury mechanisms including motor vehicle traffic, transport, and environmental incidents. Compared to Group 3, Group 1 had higher probability of experiencing major injuries and receiving ICU/surgical care. Injury severity was largely similar between Groups 1 and 2.

This cross-sectional study provides suggestive evidence that older adults with dementia and agricultural injuries experience more severe outcomes than those in nonagricultural settings. Future research should explore this group in greater depth as well as the implications for dementia caregivers in agricultural communities.