THURSDAY, Jan. 3 (HealthDay News) -- Having a traumatic brain
injury at some time in your life doesn't raise the risk of dementia
in old age, but it does increase the odds of re-injury, a new study
finds.
"There is a lot of fear among people who have sustained a brain injury that they are going to have these horrible outcomes when they get older," said senior author Kristen Dams-O'Connor, assistant professor of rehabilitation medicine at the Icahn School of Medicine at Mount Sinai Medical Center in New York City.
"It's not true," she said. "But we did find a risk for re-injury."
The 16-year study of more than 4,000 older adults also found
that a recent traumatic brain injury with unconsciousness raised
the odds of death from any cause in subsequent years.
Those at greatest risk for re-injury were people who had their
brain injury after age 55, Dams-O'Connor said. "This suggests that
there are some age-related biological vulnerabilities that come
into play in terms of re-injury risk," she said.
Dams-O'Connor said doctors need to look out for health issues
among older patients who have had a traumatic brain injury. These
patients should try to avoid another head injury by watching their
balance and taking care of their overall health, she said.
To investigate the consequences of a traumatic brain injury in
older adults, the researchers collected data on participants in the
Adult Changes in Thought study, conducted in the Seattle area
between 1994 and 2010. The participants' average age was 75.
At the start of the study, which was published recently in the
Journal of Neurology, Neurosurgery & Psychiatry, none of
the participants suffered from dementia. Over 16 years of
follow-up, the researchers found that those who had suffered a
traumatic brain injury with loss of consciousness at any time in
their lives did not increase their risk for developing Alzheimer's
or other forms of dementia.
The risk of another traumatic brain injury, however, more than
doubled if the first injury occurred before age 25 and almost
quadrupled if the injury happened after age 55. Similarly, a recent
traumatic brain injury more than doubled the odds of death from any
cause, the study found.
Dams-O'Connor's group plans to look at risk factors to try to
understand why some people have poor long-term prognosis after a
brain injury.
One expert said genetics may play a role. "My guess is that the
risk for post-traumatic-brain-injury Alzheimer's disease has a
genetic component with some genes increasing risk and others
offering protection," said Dr. Sam Gandy, associate director of the
Mount Sinai Alzheimer's Disease Research Center in New York
City.
These findings should not be confused with those regarding
athletes who suffer brain injuries, Gandy said.
"The dramatic examples of former [National Football League] players, hockey players and wrestlers who have an unusual illness, marked by depression, agitation and psychosis are quite different from Alzheimer's disease patients who tend to be apathetic," he said.
"Much remains to be discovered about the role of lifelong traumatic brain injury history, including severity and nature of torque and other physical factors, and late-life mental decline," Gandy said.
Another expert, Dr. Danny Liang, a neurosurgeon at North
Shore-LIJ Cushing Neuroscience Institute in Manhasset, N.Y., thinks
these findings are too narrow to say much about the risk of
dementia as a result of traumatic brain injury.
"The study is restricted to a limited population so it's hard to extrapolate these findings to other populations," he said. "It is also possible that there were people who had traumatic brain injury who did develop dementia before age 65, so they were not included in the study," Liang said.
There also was no data on injury severity or duration of
unconsciousness, he said. Brain injuries differ, and knowing the
severity is important to determine the ultimate outcome, he
said.
More information
For more information on traumatic brain injury, visit the
U.S. Centers for Disease Control and Prevention.