# Transforming Research and Clinical Knowledge in Older Veterans with Acute Traumatic Brain Injury (TRACK-VA)

> **NIH VA I01** · VETERANS AFFAIRS MED CTR SAN FRANCISCO · 2024 · —

## Abstract

Acute traumatic brain injury (TBI) in older veterans is an under-recognized public health emergency for
Veterans Health Administration (VHA). The highest and fastest rising incidence of TBI in the U.S. is in older
adults, mostly due to ground-level falls. Compared with younger patients, older adults with TBI have higher
mortality, lower rates of functional recovery, and may be at especially high risk for post-TBI dementia. Details
of clinical and biological characteristics of older Veterans with acute TBI are incomplete, and insufficient to
implement evidence-based practice guidelines or plan clinical trials. However, pre-existing TBI,
medical/psychiatric conditions, and substance use – common in older Veterans – are emerging risk factors for
sustaining TBI and for worse outcomes after TBI. There is an urgent need to comprehensively characterize
acute TBI in older Veterans presenting to VA hospitals to inform effective interventions to optimize outcomes.
Barriers to progress are: 1) Older adults, especially older Veterans, are underrepresented in acute TBI
research. The 18-site NINDS-funded Transforming Research and Clinical Knowledge in TBI study (TRACK-
TBI; U01NS086090) had no VA sites and, per protocol, excluded older adults with pre-existing conditions; (2)
Emerging TBI blood-based and neuroimaging biomarkers have not been validated in older Veterans, many
with pre-existing conditions and military relevant exposures that may reduce accuracy. To begin to address
age-related barriers to progress, we received funding from NIH for the Transforming Research and Clinical
Knowledge in Geriatric TBI (TRACK-GERI; R01 NS110944 2019-2024) study, a 5-year 2-site TRACK-TBI
Network prospective cohort of acute geriatric TBI in patients presenting to Level 1 trauma centers. However,
this study will not capture patients who present to VAs or non-trauma center Emergency Departments (ED).
Thus, TRACK-GERI will not elucidate the unique features of geriatric TBI in Veterans presenting with mostly
mild TBI to VA EDs. To fill this gap, we propose to leverage the existing TRACK-TBI Network data and
expertise of our exceptional multi-disciplinary team at SFVA/UCSF to achieve these scientific aims: Aim 1:
Characterize baseline and 12-mo longitudinal clinical features using TBI Common Data Elements (CDEs)
among Veterans age ≥65y enrolled in the TRACK-TBI and TRACK-GERI studies with acute TBI. We will
analyze existing data collected at TRACK-TBI’s 18 non-VA Level 1 trauma centers and explore comparisons to
civilians (existing geriatric cohort data consists of N>60 Veterans, N>250 civilians).Aim 2: Assemble a new
prospective cohort of Veterans age ≥65y presenting to SFVA ED ≤72h after TBI who received CT (“TRACK-
VA”) and deeply phenotype clinical and biological features over 12-months using TBI CDEs. Enroll 70 TBI
patient/study-partner dyads and 30 matched ED controls (with medical/orthopedic conditions discharged from
the ED), perform baseline clinical assessments (pr...

## Key facts

- **NIH application ID:** 10909794
- **Project number:** 5I01CX002346-03
- **Recipient organization:** VETERANS AFFAIRS MED CTR SAN FRANCISCO
- **Principal Investigator:** Pratik Mukherjee
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2024
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2022-01-01 → 2026-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10909794

## Citation

> US National Institutes of Health, RePORTER application 10909794, Transforming Research and Clinical Knowledge in Older Veterans with Acute Traumatic Brain Injury (TRACK-VA) (5I01CX002346-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10909794. Licensed CC0.

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