Aging & Longevity
Traumatic Brain Injuries to Seniors Linked to Higher
Senior citizens are often warned of the risks
associated with falls that are common for elderly – now add dementia to
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
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.