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Brain injury in veterans tied to higher Alzheimer's risk

Jun. 26, 2014 - 06:08PM   |  
U.S. Navy Capt. Michael Wagner, MD, a neurologist and Traumatic Brain Injury Director at the Kandahar Air Field Role 3 Medical Treatment Facility, examines a soldier after he was exposed to an IED blast, in 2010.
U.S. Navy Capt. Michael Wagner, MD, a neurologist and Traumatic Brain Injury Director at the Kandahar Air Field Role 3 Medical Treatment Facility, examines a soldier after he was exposed to an IED blast, in 2010. (Jack Gruber/USA Today)
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Veterans who suffered brain injuries while in the service were more likely to develop Alzheimer’s decades later, according to a new study published Wednesday in the journal Neurology.

Although it has long been known that boxers who suffer severe repeated blows to the head are at higher risk for dementia in old age, studies have been mixed about whether head trauma can lead to the mental decline of dementia.

In the new study, researchers at the University of California-San Francisco and the San Francisco Veterans Affairs Medical Center looked at the records of 188,764 U.S. veterans, age 55 and above, who had been seen at a VA medical facility in the early 2000s and at least once since. None of them had dementia at the beginning of the study. By the end, 16 percent of those who had suffered a serious head injury had been diagnosed with dementia, compared to only 10 percent of those without a brain injury — a 60 percent increase in those with head injuries.

Veterans who had multiple risk factors — such as post-traumatic stress disorder, depression, or heart disease in addition to head injury — were more likely to develop dementia.

It’s not clear why head injuries may play a role in dementia, said lead researcher Deborah Barnes, an epidemiologist at the VA and associate professor at UCSF, but it’s possible that the more insults the brain experiences, the more vulnerable it becomes to dementia. It’s also plausible that a brain injury could lead directly to the development of brain plaques that eventually cause Alzheimer’s, she said.

Other researchers were quick to note that the injuries studied were severe, traumatic brain injuries, not the kind of everyday concussions that happen on the soccer field.

There’s no evidence that those kind of milder injuries lead to later problems, said Jeffrey Kutcher, a neurologist, concussion expert and associate professor at the University of Michigan Health System in Ann Arbor.

Dementia is caused by a variety of factors, Kutcher said, including genetics, lifestyle and injuries. As it’s impossible to completely prevent injuries, more effort should be spent on treating and fending off dementia, he said.

“Head trauma is just one piece of a big puzzle,” added Rodolfo Savica, a neurologist with University of Utah Health Care in Salt Lake City, who wrote an editorial accompanying the Neurology study. “All of us receive hits in our heads. All of us. Ever since we were kids.”

Barnes explained that her numbers show population averages, not what will happen to an individual who has a brain injury.

“It doesn’t mean that every single person who has even repeated traumatic brain injuries will develop dementia,” she said. “This is just shifting people’s risk a little bit one way or the other.”

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