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   Traumatic brain injury in older adults linked to increased dementia risk   
      
   Last updated: Tue 28 Oct 2014 at 12am PST   
   Alzheimer's / Dementia Neurology / Neuroscience Seniors / Aging add your   
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   A new study published in JAMA Neurology suggests that for adults aged 55 years   
   and older, traumatic brain injury may be linked to an increased risk of   
   dementia.   
   MRI scans of the brain   
   Researchers found that traumatic brain injury sustained at the age of 55 or   
   over may increase the risk of dementia.   
   This is not the first study to suggest such a link. Earlier this year, Medical   
   News Today reported on a study revealing that 16% of veterans who had   
   experienced a traumatic brain injury (TBI) developed dementia, compared with   
   only 10% of veterans who had    
   not experienced a TBI.   
      
   However, the researchers of this latest study - including Dr. Raquel C.   
   Gardner of the University of California-San Francisco - note that other   
   studies have not found a link between TBI and dementia, but such studies have   
   been subject to many limitations.   
      
   "Even among studies that report a positive association between TBI and   
   dementia, marked variability exists in the magnitude of reported risk," the   
   researchers add, "which may be due to differences in TBI severity, age of   
   patients, and follow-up period -    
   with some being as short as 2 years - among studies."   
      
   According to the Centers for Disease Control and Prevention (CDC), 60% of all   
   hospitalizations for TBI occur among individuals aged 55 and older. The   
   highest rates of TBI-related emergency department (ED) visits, inpatient stays   
   and deaths occur among    
   individuals aged 75 years and older.   
      
   Dr. Gardner and colleagues say such figures emphasize the need to gain a   
   better understanding of the relationship between TBI and dementia - something   
   they set out to do with this latest study.   
      
   Moderate, severe TBI at age 55 or older linked to increased dementia risk   
   Using information from a health database of ED and inpatient visits in   
   California, the research team identified 164,661 patients aged 55 years and   
   older who were recently diagnosed with TBI or non-TBI body trauma (NTT) -   
   fractures that occurred in areas    
   of the body other than the head or neck.   
      
   The researchers note that few studies assessing the link between TBI and   
   dementia have used patients with NTT as controls. Doing so strengthens the   
   study results, they say, as it mitigates the possibility of reverse causality.   
      
   Patients were followed-up for an average of 5.7 years and had no signs of   
   dementia at study baseline.   
      
   Of the 51,799 patients diagnosed with TBI, 8.4% developed dementia, compared   
   with 5.9% of patients diagnosed with NTT. TBI patients also had a shorter   
   duration between trauma and development of dementia, at 3.1 years compared   
   with 3.3 years among NTT    
   patients.   
      
   Further analysis revealed that moderate to severe TBI at age 55 years or older   
   was associated with increased risk of dementia, as was mild TBI at age 65   
   years or older.   
      
   Commenting on their findings, the team says:   
      
   "Given the high rates of TBI in the population, primary prevention of TBI,   
   which in this study was overwhelmingly (66.4%) due to falls, is critical.   
      
   The effect of mild TBI sustained in middle age or earlier deserves further   
   study during a longer period of follow-up. In addition, further research is   
   needed to understand the mechanisms of post-TBI dementia to inform secondary   
   preventive strategies."   
      
   They add that there are some limitations to their study. For example, they   
   used information from ED and inpatient databases, in which patients could have   
   been subject to misdiagnoses or miscoding.   
      
   Furthermore, they lacked data on patients' family history, educational status   
   and previous TBIs, illnesses or operations, which could have influenced the   
   results.   
      
   In an editorial linked to the study, Dr. Steven T. DeKosky, of the University   
   of Pittsburgh School of Medicine, PA, notes that although the researchers   
   cited having NTT patients as controls a study strength, it is also a   
   limitation.   
      
   "Unfortunately, there was not a non-trauma control group included, which may   
   have answered the question of whether NTT (i.e. body trauma itself) raised the   
   risk of dementia significantly above age-equivalent controls without non-brain   
   trauma (perhaps    
   from inflammation or other complications)," he says, adding:   
      
   "If the non-brain trauma population had incident rates similar to   
   non-traumatized age-equivalent controls, trauma could be ruled out as a risk   
   factor and more specific effects of brain injury can be examined for their   
   contribution to eventual dementia."   
      
   MNT recently reported on a study revealing that a walnut-enriched diet slowed   
   progression of Alzheimer's - the most common form of dementia - in mice.   
      
   Written by Honor Whiteman   
      
      
      
   http://www.medicalnewstoday.com/articles/284486.php   
      
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