Traumatic Brain Injuries — HEALTH REPORT

Concussion in 20s could increase the risk of dementia by 60 per cent, Lancet study finds

A nationwide study of 2.8 million Danes found those who sustained one or more traumatic brain injuries (TBI) over a 36-year period were 24 per cent more likely to be diagnosed with dementia than those without a history of TBI.

A single TBI characterized as "severe" increased the risk by 35 percent; a single "mild" TBI or concussion increased the risk by 17 percent, the research indicated.

The authors found that someone with one TBI had a risk of developing dementia after age 50 that was 22 per cent higher than someone with no diagnosed brain injury, this was 33 per cent higher with two TBIs or 200 per cent higher with five or more.

But Prof Fann explained that the actual risk of getting dementia after a brain injury was small, as less than 5% of the people in the study ended up getting the condition and of those, about 5% had suffered a TBI. "The attributable risk of traumatic brain injury to different exposures and how these change across time needs policy attention, given it is likely that prevention of these need be considered at societal, community, and local levels".

Lead author Professor Jesse Fann, from the University of Washington School of Medicine in Seattle, said that "individuals with a history of traumatic brain injury, including those with less severe injuries, have an increased risk of developing dementia, even decades after the injury". More than 50 million people experience a TBI each year and Professor Fann said tackling this could help lower the overall risk of dementia which already affects 47 million people worldwide, but is expected to double in the next 20 years as life expectancies increase. For example, individuals having a TBI in their 20s were 63 per cent more likely to develop dementia about 30 years later compared to those who didn't sustain a TBI in their 20s.

But it would be advisable for people who had suffered a severe knock to the head - whether in a fall, vehicle accident, through contact sport, or an assault - to take extra precautions.

The new study took account of other influences on dementia risk including diabetes, heart disease, depression and substance abuse.

They did, however, caution that the findings do not suggest that everyone who suffers a traumatic injury will go on to develop dementia. For their first T.B.I. diagnosis, 85 percent were this mild type.

While the paper did not specifically look at brain injuries caused through sport, Dr Mahmoud Maina, research fellow at the University of Sussex, said the study "reinforces the fact that sports in which head injury occurs are risky and may make us susceptible to dementia".

The researchers identified a cumulative effect, with dementia risk rising with repeated episodes of brain injury.

"If someone has a traumatic brain injury or concussion, they need to strictly follow the protocols to leave the game and get the proper assessment and treatment that is necessary", Fann said.

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