Published: Thu, April 12, 2018
Health Care | By Alice Shelton

New research finds link between concussion and dementia

New research finds link between concussion and dementia

People who suffer a traumatic brain injury (TBI) may face an increased risk of developing dementia, including Alzheimer's disease, one of the largest studies of its kind has found. But even a single mild T.B.I. was tied to an increased risk of dementia.

The researchers found that 4.7 percent of individuals had at least one TBI during 1977 to 2013 and 4.5 percent had incident dementia during 1999 to 2013.

Jesse R. Fann, M.D., from the University of Washington in Seattle, and colleagues examined the correlation between TBI and subsequent long-term dementia risk in a nationwide population-based observational cohort study.

Research involving three million people shows traumatic brain injury increases the risk of dementia by 24% over 36 years. The researchers found that the risk of dementia increased by 33 percent for two or three TBIs, 61 percent for four injuries and 183 percent for five or more injuries. Even compared to that group, the TBI group had higher risk for dementia.

Measuring pupil reactivity to light could assist with treatment decisions for brain injuries, they say. There are about 10 million new dementia cases each year. TBI occurs when an external force such as a bump or blow to the head disrupts the normal function of the brain.

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Previous studies have been conflicting, because of small sample sizes and short follow-up periods.

Dementia remained relatively rare: only 4.7 percent of study participants developed dementia at all, a total of 126,734 people.

And, "our findings do not suggest that everyone who suffers a traumatic brain injury will go on to develop dementia in later life", Fann added.

However, the study results could lead people with TBI histories to change certain behaviors like alcohol and tobacco use, regular exercise and treating hypertension, diabetes and depression to limit other potential risk factors for dementia. But it would be advisable for people who had suffered a severe knock to the head - whether in a fall, auto accident, through contact sport, or an assault - to take extra precautions. "Greater efforts to prevent TBI and identify strategies to ameliorate the risk and impact of subsequent dementia are needed". For example, individuals having a TBI in their 20s were 63% more likely to develop dementia about 30 years later compared to those who didn't sustain a TBI in their 20s (overall dementia rate 0.55 per 1000 person years vs 0.34 per 1000 person-years); whereas individuals sustaining a TBI in their 30s were 37% more likely to develop dementia 30 years later compared with those without a TBI in their 30s (1.67 per 1000 person-years vs 1.22 per 1000 person-years; figure 2).

The researchers note that the absolute risk remains low, but one must remain especially mindful nevertheless.

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