Professor Jonathan Schott of UCL's Institute of Neurology said the research provides "perhaps the best evidence yet that traumatic brain injury is a risk factor for dementia", but said further work was required to differentiate types of injuries, such as sport-related concussions, and how they affect the brain. They assessed the long-term risk of dementia in people who had suffered a TBI, compared to those without a TBI, and also those who had experienced physical traumas that did not involve the brain or spine, such as fractured bones.
"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.
But the study did not prove that TBIs cause dementia risk to rise, just that there's an association.
However, even a mild TBI (concussion) increased the risk by 17%.
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The researchers identified a cumulative effect, with dementia risk rising with repeated episodes of brain injury. According to the study authors, more than 50 million people every year experience a traumatic brain injury.
Responding to the study, Dr Mahmoud Maina, a research associate at the University of Sussex said: "The findings are truly novel due to the large sample size employed, in-depth history collected and follow-ups".
Over 36 years, 132,093 individuals (4.7%) had at least one TBI diagnosis, most (85%) were mild in severity. The study also examined the impact of sustaining multiple separate brain injuries and the likelihood of subsequently developing dementia. But he said the findings might lead people with TBI histories to change their behaviors toward other potential risk factors for dementia, such as limiting alcohol and tobacco use, engaging in regular exercise, preventing obesity, and treating hypertension, diabetes, and depression.
A traumatic brain injury can be caused by a fall, a traffic accident, a sports accident or a violent attack. For example, individuals having a TBI in their 20s were 63% more likely to develop dementia about 30 years later compared to those who didn't sustain a TBI in their 20s (overall dementia rate 0.55 per 1000 person years vs 0.34 per 1000 person-years); whereas individuals sustaining a TBI in their 30s were 37% more likely to develop dementia 30 years later compared with those without a TBI in their 30s (1.67 per 1000 person-years vs 1.22 per 1000 person-years; figure 2). Between 1999 and 2013, 126,734 people (4.5%) aged 50 or older were diagnosed with dementia.
The researchers note that the absolute risk remains low, but one must remain especially mindful nevertheless.
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