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BRAIN INJURY in the NEWS
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Mild TBI Doubles Dementia Risk, Even Without LOC

Exerpted from Medscape | By Batya Swift Yasgur, MA, LSW

Sensitivity analyses yielded similar results.

"Not everyone who has experienced a concussion or brain injury will go on to develop dementia; our findings just suggest their risk is higher," commented Barnes.

She added that additional studies are needed to determine whether the findings are generalizable to nonveterans who have had TBI.

"However, we believe that they are likely to be generalizable, since studies of moderate to severe TBIs have had similar results in both populations," she said.

"In addition, although we did not have information on the cause of the TBIs, we believe that many of them were related to things like falls and car accidents rather than military service," she said.

She added, "It is important to note, however, that all of the TBIs in our study were severe enough that veterans sought medical care, even if they did not lose consciousness."

Screen for Dementia

Commenting on the study for Medscape Medical News, Ramon Diaz-Arrastia, MD, PhD, professor of neurology, Perelman School of Medicine, University of Pennsylvania, in Philadelphia, who was not involved with the study, called it "one of the more comprehensive and definitive" studies in comparison to previous studies that examined the association between TBI and dementia risk.

This is important, because not all prior studies were in agreement about the risk. Some were "underpowered or false negatives, while this study has a sufficiently large sample size to give confidence and precision to the finding," said Diaz-Arrastia, who is the coauthor of an accompanying editorial.

"Although the increased risk was modest, given that dementia is so common numerically, the magnitude of people who are at increased risk of dementia from TBI is actually pretty high," he noted.

One take-home message is that "clinicians working with people who have had TBI should be more careful in screening for cognitive problems and dementia, as well as mood and affective problems," he said.

Barnes added that those who have had a TBI "may be able to reduce their [dementia] risk through other activities, such as engaging in physical, mental, and social activity and eating a brain-healthy diet."

The study was supported by the US Army Medical Research and Material Command, the US Department of Veterans Affairs, and the Chronic Effects of Neurotrauma Consortium. Dr Barnes, Dr Diaz-Arrastia, the other study authors, and the editorialists have disclosed no relevant financial relationships.

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