The First Year Matters: Lifestyle Behaviors and Five-Year Cardiometabolic Risk Factor Accumulation After Traumatic...

Area of Science:

• Neurology
• Cardiology
• Public Health

Background:

• Traumatic brain injury (TBI) is increasingly recognized as a chronic condition.
• The long-term impact of early lifestyle choices on cardiometabolic health post-TBI is not well understood.

Purpose of the Study:

• To investigate the association between lifestyle behaviors at one year post-TBI and the development of cardiometabolic risk factors by five years.
• To analyze data from the Traumatic Brain Injury Model Systems (TBIMS) National Database.

Main Methods:

• Retrospective cohort analysis of adults with TBI, utilizing one-year and five-year interview data.
• Exposure: A composite score of favorable lifestyle behaviors (non-smoking, non-heavy alcohol use, healthy BMI, regular exercise).
• Outcome: Incident accumulation of at least two new cardiometabolic conditions (hypertension, diabetes, high cholesterol) between years 1 and 5.

Main Results:

• Among 581 participants in the primary analytical cohort, 6.7% experienced the primary endpoint.
• Each additional favorable lifestyle behavior at one year was associated with significantly lower odds of developing cardiometabolic risk factors by five years (OR, 0.63; 95% CI, 0.41-0.98).
• Findings remained consistent after adjusting for cognitive function and using Firth logistic regression, though results are exploratory due to cohort selection and small event numbers.

Conclusions:

• Favorable lifestyle profiles one year after TBI are associated with reduced accumulation of cardiometabolic risk factors by five years.
• These results highlight the potential benefit of prevention-oriented follow-up care for TBI survivors.
• Causality is not established, and the findings require further validation in broader TBI populations.