Traumatic Brain Injury and Dementia
There has been a lot of media attention lately about head injuries occurring during sports games and how they are dealt with. Head Injuries can have long lasting effects that require ongoing treatment and support. They can impact on your cognitive and executive functions and certain types of brain injuries may also increase the risk of developing certain problems such as epilepsy.
On 2 May 2019, the BBC published an article considering whether dementia was the greatest health challenge of our time. This reminded me of an earlier BBC article which I had read which was published on 11 April 2018 raising concerns about the link between head injuries and dementia. This article was based on a research study carried out in Denmark which had found that people who had suffered one or more traumatic brain injuries were 24% more likely to get dementia than those who had not. Another note-worthy statistic was that people who had suffered even one mild traumatic brain injury, such as a concussion, were 17% more likely to get dementia, with the risk increasing with the number of traumatic brain injuries and the severity of the injury.
What is dementia?
Dementia is a syndrome (a group of related symptoms) associated with an ongoing decline of brain functioning. There are over 200 subtypes of dementia, with the most common being Alzheimer’s disease. Some of the symptoms include problems with:
- memory loss
- thinking speed
- mental sharpness and quickness
- difficulties carrying out daily activities.
What causes dementia?
As there are over 200 subtypes of dementia, it is not surprising that there are several different diseases that can cause dementia. Many of these diseases are associated with an abnormal build-up of proteins in the brain which causes nerve cells to function less well and become damaged. This in turn causes different areas of the brain to be affected, resulting in a range of symptoms being displayed by a person suffering from dementia.
Can head injuries cause dementia?
Although some studies have reported a causal link between traumatic brain injuries and dementia, the exact relationship between the two is not entirely conclusive. This is due to a range of issues during the studies such as insufficient sample size and length of follow-up, a lack of accurate data collection, and the possibility of recall bias.
The Denmark study which the BBC article referred to was a step in the right direction, as they tried to overcome some of the problems with previous studies. For example, the study was based on nearly 3 million people and the length of the follow up was an average of 10 years. The researchers also used reliable national databases and looked at dementia cases that only developed since the head injury. They also adjusted their analysis for various health factors that could have influenced any link seen.
Some of the results, after taking into consideration confounding variables, were as follows:
- All types of traumatic brain injuries were associated with a 24% increased risk of dementia when compared with people who hadn’t had a traumatic brain injury;
- The risk figure was very slightly higher for men than women;
- The risk appeared to increase with the number of traumatic brain injuries a person had; and
- Traumatic brain injury was also associated with a higher risk of dementia when compared with other traumatic injuries not involving the brain or spine.
Conclusions from the Denmark study
Whilst these statistics may appear to be alarming, the NHS have helpfully prepared a follow up publication setting out the results from the study, as well as the limitations of the results and the conclusions reached.
The NHS have pointed out that although the Denmark study furthered our understanding of the possible increased risk in developing dementia following a traumatic brain injury, the size of this risk increase is still very small. People who have had a traumatic brain injury have a 5.1% risk of developing dementia, compared with a 4.5% risk for people who haven’t experienced a traumatic brain injury. The increase itself is therefore very small.
An increased awareness around head injuries should always be welcomed, but we should also be careful about taking headline news as conclusive evidence on any given subject, especially when it involves something so significant.
Further guidance about Dementia can be found using the links below:
Rujina Hoque is a solicitor in the Adult Brain Injury team at Bolt Burdon Kemp. If you or a loved one have a claim you can contact Rujina free of charge and in confidence on 020 7288 4866 or at firstname.lastname@example.org. Alternatively, complete this form and one of the solicitors in the Adult Brain Injury team will contact you. Find out more about the Adult Brain Injury team here.