Tue, Jul 19, 2011 - Page 7 News List

Brain injury raises dementia risk: study

LEGACY OF WAR:A US study of more than 280,000 veterans challenges the popular view that only moderate or severe brain injuries predispose people to dementia

AP, PARIS

A large study in older veterans raises fresh concern about mild brain injuries that hundreds of thousands of US troops have suffered from explosions in recent wars. Even concussions seem to raise the risk of developing Alzheimer’s disease or other dementia later in life, researchers found.

Closed-head, traumatic brain injuries are a legacy of the Afghanistan and Iraq wars. Body armor is helping troops survive bomb blasts, but the long-term effects of their head injuries are unknown.

The study, reported yesterday at the Alzheimer’s Association International Conference in France, challenges the current view that only moderate or severe brain injuries predispose people to dementia.

“Even a concussion or a mild brain injury can put you at risk,” said Laurie Ryan, a neuropsychiatrist who used to work at Walter Reed Army Medical Center and now oversees Alzheimer’s grants at the US National Institute on Aging.

The study was led by Kristine Yaffe, a University of California professor and director of the Memory Disorders Clinic at the San Francisco VA Medical Center. The US Department of Defense and the National Institutes of Health paid for the work.

“It’s by far the largest” study of brain injury and dementia risk, she said. “It’s never been looked at in veterans specifically.”

Researchers reviewed medical records on 281,540 veterans who got care from US Department of Veterans Affairs hospitals from 1997 to 2000 and had at least one follow-up visit from 2001 to 2007. All were at least 55 and none had been diagnosed with dementia when the study began. This older group was chosen because dementia grows more common with age, and researchers needed enough cases to compare those with and without brain injuries.

Records showed that nearly 5,000 of the veterans had suffered a traumatic brain injury, or TBI, ranging from concussions to skull fractures. Researchers don’t know how long ago the injuries occurred. Many participants were Vietnam War vets and their injuries were during active duty. None were due to strokes — those cases were weeded out.

Over the next seven years, more than 15 percent of those who had suffered a brain injury were diagnosed with dementia versus only 7 percent of the others — a more than doubled risk. Severity of the injury made no difference in the odds of developing dementia.

Troops will need close monitoring in the years ahead and treatment for post-traumatic stress, depression and other conditions that can lead to cognitive problems, experts said.

“While we don’t want people frightened to think they’re going to be permanently impaired, a mild traumatic brain injury does not necessarily mean” no long-term problems, said Gregory O’Shanick, a psychiatrist and chairman of the board of the advocacy group Brain Injury Association of America.

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