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August 6, 2014
Army Lt. Col. (Dr.) Margaret Swanberg checks the pupils of Army Spc. Michael Woywood for dilation during a concussion evaluation demonstration at Forward Operating Base Hammer in Iraq in 2008. Research has confirmed a link between TBIs and increased dementia risk later in life. (Photo by Pfc. Michael Schuch)
Veterans diagnosed with a traumatic brain injury may be at greater risk for developing dementia later in life, according to a recently published study.
The research, published in the July 22, 2014, issue of Neurology, examined more than 188,000 Veterans over the age of 55 for nine years. During that time, 16 percent of Veterans with a past diagnosis of TBI developed dementia, compared with 10 percent among those with no history of TBI. Overall, having TBI was associated with a 60 percent increase in the risk of developing dementia for older Veterans, after statistical adjustments for factors such as age, medical conditions, depression, and posttraumatic stress disorder.
Dementia includes any number of disorders affecting the brain. Symptoms include impaired intellectual and cognitive functioning as well as behavioral and personality changes. The most common form of dementia, Alzheimer's disease, currently affects some 5.3 million people in the U.S. and is the sixth leading cause of death in the country.
"There seems to be growing evidence that traumatic brain injury may be a trigger for earlier onset of dementia later in life, and our results add to this evidence," lead author Dr. Deborah Barnes of the San Francisco VA Medical Center told Wall Street OTC in July.
Although TBI has emerged as a signature wound of the wars in Iraq and Afghanistan, injuries of this type can be sustained through any number of civilian activities. Sports injuries and car accidents are two common causes. "If an older patient has a history of traumatic brain injury, then doctors need to look more closely for cognitive symptoms," said Barnes, who is also an associate professor at the University of California, San Francisco.
The results, according to Barnes, raise concerns about the long-term consequences of TBI, particularly in young Veterans of Iraq and Afghanistan.
The researchers say Veterans with head injuries may be able to lower their risk of developing dementia by staying active, both mentally and physically, and getting treatment for any mental health conditions.
"We found there was an additive relationship between mental health conditions and head injuries," Barnes told Reuters Health. "Veterans who had both of these risk factors were more likely to develop dementia than those who had only one. In addition, they may be able to lower the risk of dementia by doing their best to minimize future head injuries by doing simple things to protect their brain, like wearing helmets and seat belts."
On a related note, Dr. Michael Weiner, also of the San Francisco VA Medical Center, is leading a study looking at the link between TBI or PTSD and dementia in Vietnam Veterans. The study, funded by the Department of Defense, is part of the national Alzheimer's Disease Neuroimaging Initiative (ADNI), which Weiner leads.
Nationwide, approximately 1,000 Vietnam Veterans will participate in screening interviews and 500 will be interviewed by telephone. Approximately 300 Vietnam Veterans will be eligible to complete the entire study. The study will include brain scans, lumbar punctures (to check levels of amyloid in cerebrospinal fluid), medical exams, and neuropsychological tests. Interested Veterans can visit www.adni-info.org/ADNIDOD or call 1-800-773-4883.