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Aging & Longevity

Traumatic Brain Injuries to Seniors Linked to Higher Dementia Risk

Senior citizens are often warned of the risks associated with falls that are common for elderly – now add dementia to that risk

Oct. 27, 2014 – There are frequent warnings to senior citizens about the risk of falling. It has long been recognized as a high risk for serious bodily injury to aging bodies. Researchers have now found that one of the consequences of falling – traumatic brain injury (TIB) – is associated with an increased risk of dementia in adults 55 years and older, according to their report published online by JAMA Neurology.

A moderate to severe TIB is associated with an increase in dementia risk for adults 55 years of age and older, they report. But, for senior citizens – age 65 and older – it only takes a mild TBI to make dementia look more likely.

The scientist began their research to clarify conflicting studies that have tried to establish if there is a link between a single TBI and the risk of developing dementia

 

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The Centers for Disease Control and Prevention says that Americans 55 years and older account for more than 60 percent of all hospitalizations for TBI. The highest rates of TBI-related emergency department (ED) visits, inpatient stays and deaths, however, are happening among those patients 75 years and older.

Therefore, understanding the effects of a recent TBI and the subsequent development of dementia among middle or older adults has important public health implications.

Researchers Raquel C. Gardner, M.D., of the University of California, San Francisco, and colleagues examined the risk of dementia among adults 55 years and older with recent TBI compared with adults with non-TBI body trauma (NTT), which was defined as fractures but not of the head or neck.

The study included 164,661 patients identified in a statewide California administrative health database of emergency and inpatient visits.

In the study, a total of 51,799 patients with trauma (31.5 percent) had TBI. Of those, 4,361 patients (8.4 percent) developed dementia compared with 6,610 patients (5.9 percent) with NTT (other body trauma).

The average time from trauma to dementia diagnosis was 3.2 years and it was shorter in the TBI group compared with the NTT group (3.1 vs. 3.3 years).

Moderate to severe TBI was associated with increased risk of dementia at 55 years or older, while mild TBI at 65 years or older increased the dementia risk.

 “Whether a person with TBI recovers cognitively or develops dementia, however, is likely dependent on multiple additional risk and protective factors, ranging from genetics and medical comorbidities to environmental exposures and specific characteristics of the TBI itself,” the authors note.

Editorial: Role of Big Data in Understanding Late-Life Cognitive Decline

In a related editorial, Steven T. DeKosky, M.D., of the University of Pittsburgh School of Medicine, points out that the study leaves some questions unanswered.

He writes that Gardner and colleagues “used a very large database to examine the risk of dementia following significant trauma, specifically whether body trauma (fractures) or traumatic brain injury (TBI) differed in dementia incidence during follow-up.”

“Unfortunately,” he writes, “there was not a nontrauma 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 nonbrain trauma (perhaps from inflammation or other complications).”

“Judicious use of data by skilled researchers who are familiar with the entire range of dementia research from pathobiology to health care needs will enable us to ask important questions, evolve new or more informed queries, and both lead and complement the translational questions that are before us. Dementia is both a global problem and a pathological conundrum; thus, the complementary use of big data and basic neuroscience analyses offers the most promise,” he concludes.

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