Assessing The Incidence Of Traumatic Head Injuries
This is the first study that has assessed the incidence of head and traumatic brain injuries among persons with Alzheimers disease. Falls are the most common cause of head injuries in older adults, and individuals with Alzheimers disease are known to have a higher risk of falling due to cognitive decline.
The findings of this study highlight the importance of fall prevention, as head injuries can shorten the life expectancy and deteriorate a persons functional capacity.
For individuals with Alzheimer disease, head injuries may lead to the loss of activities of daily living and independence, and to the need of residential care even at early stages of the disease.
Biomarkers Of Axonal Injury
Alpha-II spectrin is the major structural component of the corticalmembrane cytoskeleton and particularly abundant in axons, and presynaptic terminalsof spectrin breakdown products have been reported in the cerebrospinal fluid of adults with severe TBI and shown a significant relationship with severityof injury and clinical outcome.,,-
Tau is an intracellular, microtubule-associated protein that is highly enriched inaxons and involved with assembling axonal microtubule bundles and participating inanterograde axoplasmic transport. Because tau is preferentially located in the axon,tau lesions are apparently related to axonal disruption.
Neurofilaments are heteropolymeric components of the neuron cytoskeleton that consistof a 68-kDa light neurofilament subunit backboned with either 160-kDa medium or 200-kDa heavy subunit side arms. After TBI, calcium influx into thecells contributes to a cascade of events that activates calcineurin, acalcium-dependent phosphatase that dephosphorylates neurofilament side arms,presumably contributing to axonal injury. Phosphorylated NF-H has been found to be elevated in theCSF of adult patients with severe TBI compared with controls.
Although research in the field of TBI biomarkers has increased exponentially over thepast 20 years, most studies have focused on severe TBI rather than on mTBI. Becausemore than 80% of patients have mTBI there is a need to explore biomarkers in thispopulation.
What Are The Different Types Of Vcid
Vascular dementia refers to progressive loss of memory and other cognitive functions caused by vascular injury or disease within the brain. Symptoms of vascular dementia may sometimes be difficult to distinguish from Alzheimer’s disease. Problems with organization, attention, slowed thinking, and problem solving are all more prominent in VCID, while memory loss is more prominent in Alzheimer’s.
Vascular cognitive impairment involves changes with language, attention, and the ability to think, reason, and remember that are noticeable but are not significant enough to greatly impact daily life. These changes, caused by vascular injury or disease within the brain, progress slowly over time.
Post-stroke dementia can develop months after a major stroke. Not everyone who has had a major stroke will develop vascular dementia, but the risk for dementia is significantly higher in someone who has had a stroke.
Multi-infarct dementia is the result of many small strokes and mini-strokes. Language or other functions may be impaired, depending on the region of the brain that is affected. The risk for dementia is significantly higher in someone who has had a stroke. Dementia is more likely when strokes affect both sides of the brain. Even strokes that don’t show any noticeable symptoms can increase the risk of dementia.
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How Do I Know I Have It
There are many symptoms of dementia, according to the CDC, with many of them outlined above. The most common are memory loss, issues with paying attention, communication problems, reasoning, judgment, and problem solving issues and visual perception beyond typical age-related changes in vision.
Specific signs that can point to dementia include getting lost in a familiar neighborhood, using unusual words to refer to familiar objects, forgetting the name of a close family member or friend, forgetting old memories, or not being able to complete tasks independently
According to the CDC, there are many risk factors of dementia.;
Age: The older you get, the more likely you are to develop dementia.
Family history: Dementia runs in the family, according to the CDC. “Those who have parents or siblings with dementia are more likely to develop dementia themselves,” they explain.;
Race/Ethnicity: According to the CDC, older African Americans are twice more likely to have dementia than whites, while Hispanics are 1.5 times more likely to have dementia than whites.
Heart Health: Those with poor cardiovascular health are more likely to develop dementia. High blood pressure, high cholesterol, and smoking can all play a role.;
Traumatic Brain Injury: “Head injuries can increase the risk of dementia, especially if they are severe or occur repeatedly,” the CDC says.;
What Did The Studies Find
Two recent studies have assessed whether traumatic brain injuries are related to dementia.
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Study 1. A research group from the University of California examined the medical records of over 350,000 US veterans, half of whom had experienced a traumatic brain injury. They found those who had a mild traumatic brain injury were more than twice as likely to develop dementia. The risk was even greater if they had lost consciousness as a result of the traumatic brain injury. People who had moderate or severe traumatic brain injuries were nearly four times as likely to develop dementia.
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Study 2. Danish researchers examined the national records of nearly 2.8 million citizens who were over 50 years old between 1999 and 2013. They found 126,734 people had dementia and 132,093 had a history of traumatic brain injury . They reported the risk of dementia was 24% higher for people who had a previous traumatic brain injury. These risks were even higher for males, people who had a more severe traumatic brain injury, and for people who had more than one traumatic brain injury in the past.
Both these studies identified cohorts of people and assessed how they changed over time. These studies also used data collected at the time of the traumatic brain injury, rather than relying on peopleâs memory of injuries in their past. They also used large samples and controlled for medical and psychiatric factors that could influence their results.
Itâs likely other factors are involved.
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Other Therapy For Dementia In Head Injury Cases
Diet
Persons who are unable to prepare food or feed themselves are in danger of becoming malnourished. Their diets must be monitored to be sure that they are getting proper nutrition. Otherwise, no special dietary prescriptions or restrictions apply.
Activity
In general, the person should be as active as possible.
- In the early phases of rehabilitation, simple physical exercises and games may improve endurance and self-confidence. These activities should gradually increase in difficulty.
- Some head-injured persons may require devices to help them with mobility . Persons using such mobility aids require monitoring to make sure they are safe.
- It may be necessary to change the surroundings to prevent falls and accidents that could cause repeat injuries.
Although medical professionals often recommend that the head-injured person resume normal activities or responsibilities, this is not always easily done.
- Persons who work at night, or whose work involves heavy machinery, hazardous conditions, or an overstimulating environment, may not be able to return to their previous positions.
- Returning to work before the person is ready may lead to failure and regression in recovery.
- The person may delay returning to work or previous activities for fear of further injury, embarrassment about disabilities, and uncertainty about abilities.
- A gradual return to work that allows the person to relearn or get used to the job is often helpful, although not always possible.
Dementia And Causes Of Head Injury
The following are the most common causes of head injury in civilians:
Use of alcohol or other substances is a factor in about half of these injuries.
Certain groups are more likely than others to sustain head injury:
- In children, bicycle accidents are a significant cause of head injury.
- Most head injuries in infants reflect child abuse. A common name for this is shaken baby syndrome.
- Older adults are especially likely to injure themselves by falling.
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What Did The Researchers Do And Find
- From all inhabitants living in Sweden above 50 years of age, three cohorts were formed. In the first cohort, 164,334 individuals with TBI were matched with controls; in the second case-control cohort, 136,233 individuals with dementia were matched with controls; and in the third cohort, 46,970 full sibling pairs discordant for TBI were evaluated for dementia during follow-up.
- In the retrospective cohort and case-control cohort, the risk of dementia was increased by four to six times the first year after TBI. Thereafter, the risk decreased rapidly but was still significant more than 30 years after the TBI.
- The risk of dementia was higher for those with a severe TBI or multiple TBIs, compared to those with one mild TBI.
- The results were generally confirmed in the sibling cohort.
How Is Dementia And Brain Injury Related
Research has shown that people who have had a moderate to severe brain injury are more likely to develop dementia in later life. The pattern of changes seen in the brain following a moderate to severe brain injury can appear similar to those changes seen in Alzheimers disease. It is not as clear whether there is an increased risk of dementia for those who have had a mild ABI, such as a brief concussion.
Repeated, mild ABIs, such as those experienced by professional sports people like boxers and footballers, are related to a condition similar to dementia known as Chronic Traumatic Encephalopathy . This condition is also seen amongst war veterans who have experienced repeated, mild head traumas. CTE has particular symptoms such as changes in mood, thinking, behaviour, and difficulties with balance and motor skills.
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A Risky Injury Even Decades Later
By looking at this large amount of data over decades, the researchers were able to find a clear association between TBIs and the risk of dementia, according to the study published today in PLOS Medicine journal.
Researchers found the risk of a dementia diagnosis was highest during the first year after the injury. During this time, people who had a TBI were 4 to 6 times as likely to get a dementia diagnosis as those without a TBI.
While the overall risk decreased over time, TBI patients still faced higher risk than those without a TBI, even 30 years later.
At the 15-year follow-up, the researchers found the risk for a dementia diagnosis increased 80 percent for people who had at least one TBI compared to those who didnt have a TBI.
Dr. Steven Flanagan, chair of the department of rehabilitation medicine at the New York University Langone Medical Center, said this study adds to a body of research linking brain injury and dementia risk.
The preponderance of the literature I would say supports that there appears to be an increased risk of dementia after traumatic brain injury, he said.
Flanagan said the use of the sibling cohort could help experts better understand dementia risk and genetics, since the siblings with a TBI were more likely to develop dementia than their brother or sister.
The study doesnt definitively say that a TBI causes dementia, just that the two appear to be linked.
Hallucinations And Delusions After A Brain Injury
My brother was 19 when he suffered a TBI. Hes made a lot of progress in six years. My familys main concern right now is that hes been talking a lot about conversations and events that clearly could not have happened or taken place. Hes also been talking to himself and gesturing like someone is with him only there is no one around. The doctor has said shes seen some TBI patients go into their own little world like this.
Our family is obviously very worried and concerned. We dont want this to set him back especially since hes come so far. Is this something that can happen to people with TBI and what suggestions might you have for us to help him?
Psychiatric issues, including hallucinations and delusions, are certainly more common after traumatic brain injury. The risk for new onset of psychiatric illness after a brain injury goes on for a long time and can be seen with any severity of traumatic brain injury. If these problem are new for your brother, a careful medical evaluation by a physician who has experience in treating patients with TBI is warranted. So the healthcare professional should take a close look at all of your brothers medications. Some medications can increase confusion or cause hallucination or delusions. Stimulant medications such as Ritalin, Adderall, and Amantadine all have this potential side effect. Evaluation should also be done to ensure these symptoms are not related to seizures.
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When To Seek Medical Care For Dementia
Any of the symptoms and signs described in the symptoms section warrants a visit to the personâs health care provider. This is true regardless of whether the person has a known head injury. Be sure the health care provider knows about any falls or accidents that could have involved even a mild head injury.
Why Might Dementia Progress Quickly
Alzheimers disease typically has a slow and gradual progression, whereas people affected by vascular dementia tend to show periodic, step-wise impairments in function. However, many factors have an impact on the development of dementia. An individuals genetic heritage will play a role, as does their general, physical health. People with cardiovascular disease or diabetes, especially if they are poorly controlled, are at risk of a faster deterioration. People who are frail with low immunity and recurrent infections are also vulnerable. Young-onset dementia tends to progress more rapidly. People who develop dementia between the ages of thirty and fifty, appear to live two years less than those whose dementia is diagnosed later in life.
Most cases of sudden confusion and rapidly progressing dementia in an elderly person are due to delirium caused by infection. Urinary infections and pneumonia can trigger acute confusion that comes on quickly, causing people to be incoherent, muddled and disorientated. Agitation, aggression and odd behaviour are also common. The good news is that the symptoms of delirium can be reversed when the infection is appropriately treated.
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Serious Head Injuries Nearly Double Your Risk Of Dementia
Mind your head
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Serious head injuries nearly double a persons risk of developing dementia. Thats the message from an analysis of over 40,000 people who sustained some kind of head injury between 1986 and 2014.
Half the people in the study had moderate-to-severe head injuries, which cause lesions in the brain and require a person to stay in hospital for three days or more. The other half had milder head injuries with no lesions, and were able to go home within a day.
Comparing the longer-term health of these two groups revealed that the risk of developing non-Alzheimers dementia is 90 per cent higher in those with moderate-to-severe injuries, says Rahul Raj at the University of Helsinki, Finland. This was the case even after taking factors like education and socioeconomic status into account, he says.
When To Get Medical Advice
It’s a good idea to see your GP if you’re worried about your memory.
If you’re worried about someone else, you should encourage them to make an appointment and perhaps suggest that you go along with them.
Memory problems are not just caused by dementia. They can also be caused by:
- medications
- other health problems
Your GP can carry out some simple checks to try to find out what the cause may be, and they can refer you to a specialist memory clinic for more tests, if necessary.
Read about when to get medical advice for symptoms of concussion and symptoms of a minor head injury.
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Head Injuries And Early Warning Signs
Several studies have looked for early warning signs of dementia in the brains of people who have experienced traumatic brain injuries.Researchers have identified the build-up of tau tangles and amyloid plaques many years after the injury in the brains of a higher proportion of people who have experienced a severe brain injury than those who had not experienced brain injury. However, we dont know if these individuals went on to develop dementia.;
Tbi As A Risk Factor For Late
there is sufficient evidence of an association between moderate and severe TBI and dementia ⦠limited/suggestive evidence of an association between mild TBI and dementia ⦠inadequate/insufficient evidence to determine whether an association exists between mild TBI and dementia.
Available data allow a rough calculation of how much of the populationâs burden of dementia is attributable to TBI. Assuming that the cumulative lifetime incidence of TBI requiring hospitalization is 10%, a reasonable estimate based on the New Zealand Christchurch Health and Development Study and a population-based telephone survey in Colorado , and given that the relative risk of dementia in individuals who had a TBI of sufficient severity as to require hospitalization ranges from 1.5- to 3-fold,â the attributable risk of dementia to TBI is in the range of 5% to 15%.
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Traumatic Brain Injury Linked To Increased Dementia Risk In Seniors
New research suggests that seniors who suffer a;concussion or traumatic brain injury;are at an increased risk to develop dementia or other mental difficulties later in life.
Traumatic brain injuries can occur in a lot of different ways, from contact during athletic activity or in the wake of a car accident, but for seniors, oftentimes falls are the biggest cause of head injury. You might think that concussions are a young mans injury, but research shows that 66 percent of people admitted to the hospital for a traumatic brain injury are over the age of 55, and the highest rate of patients with TBIs are those over the age of 75.
Because traumatic brain injuries are a real danger for older individuals, researchers wanted to take a closer look at how the brain is affected by trauma at that stage of life. To get a better understanding, researchers examined medical records of more than 164,000 patients over the age of 55. Some of the patients had suffered a traumatic brain injury, while others were classified as having non-TBI trauma . Follow ups were conducted at five years and seven years post-initial exam.