Head injury boosts dementia risk

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'There are 850,000 people with dementia - this number is set to rise to 1 million by 2021 and more research is urgently needed to fill the gaps in our understanding of lifestyle factors that increase dementia risk'.

"Whilst the study shows that the number, severity, and timing of head injuries influences risk, further research is required to establish the extent to which specific types of head injury (e.g. sports concussions) are or are not implicated".

Dementia affects 47 million people worldwide, a number expected to double in the next 20 years.

Previous research on links between brain injury and dementia has produced conflicting results, said the study authors writing in the journal The Lancet Psychiatry.

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Among the almost 2.8 million people observed, 4.7 per cent had at least one TBI diagnosis. Each year, there are ten million new patients.

Published on Tuesday, the study led by Jesse Fan of the University of Washington School of Medicine in Seattle capitalized on features of the national health system in Denmark that allow researchers to explore connections in health records.

Leading causes include falls, motor vehicle accidents, and assaults. People with a history of TBI had a higher fully-adjusted risk of all-cause dementia (hazard ratio, 1.24) compared to those without a history of TBI; the risk of Alzheimer's disease was also increased (hazard ratio, 1.16). For example, a person who sustained a TBI in their 20s was 63% more likely to develop dementia 30 years later compared to someone who did not sustain such an injury in their 20s.

While not every person who sustains a severe TBI will develop dementia, the findings might such people to change their behaviours toward potential risk factors for dementia, such as limiting alcohol and tobacco use, engaging in regular exercise, preventing obesity and treating hypertension, diabetes and depression, the researchers said.

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Of the population studied, 132,093 individuals (4·7 percent) had at least one TBI during 1977-2013, and 126,734 (4·5 percent) had incident dementia during 1999-2013.

For the study, the team examined 2.8 million people, and followed-up for 36 years. Even compared to that group, the TBI group had higher risk for dementia.

The authors note some limitations, including that the study included people taken from one country with a fairly similar ethnic population, so the findings can not be generalised to all ethnic groups in other countries. "Our findings do not suggest that everyone who suffers a traumatic brain injury will go on to develop dementia in later life". They also note that they did not include TBIs treated by general practitioners, so the data might not have captured some less severe TBIs.

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