Brain Injury and Dementia
By Kathryn Cherkas, Director of Programs
Adults with a history of
traumatic brain injury (TBI)
often experience the clinical
onset of Alzheimer’s disease
several years earlier than those
without TBI, states Heather
Snyder, PhD. Dr. Snyder, the
Alzheimer’s Association’s
Vice President of Medical and
Scientific Operations, also
remarks that TBI may make
people more vulnerable to not
only Alzheimer's, but other
dementias as well.
Let’s first take a step back and talk
about TBI and what it means for those
living with it and for those wanting to
prevent it. A traumatic brain injury
results from an impact to the head that
disrupts normal brain function. The
leading causes of TBI that result in
emergency department visits are falls,
being struck by an object and motor
vehicle crashes. According to the
CDC, more than 1.5 million
Americans sustain a TBI every year.
Doctors classify traumatic brain injury
as mild, moderate or severe, depending
on whether the injury causes
unconsciousness, how long
unconsciousness lasts and the severity
of symptoms. Although most traumatic
brain injuries are classified as mild
because they're not life-threatening,
even a mild traumatic brain injury can
have serious and long-lasting effects.
In all forms of traumatic brain injury,
cognitive changes are among the most
common, disabling and long-lasting
symptoms that result directly from the
injury. The ability to learn and
remember new information is often
affected. Other commonly affected
cognitive skills include the capacity to
pay attention, organize thoughts, plan
effective strategies for completing
tasks and activities, and make sound
judgments. More severe changes in
thinking skills — a hallmark
characteristic of dementia — may
develop years after the injury took
place and the person appears to have
recovered from its immediate effects.
There is no evidence that a single mild
TBI increases dementia risk. However,
emerging evidence does suggest that
repeated mild traumatic brain injuries,
such as those that can occur in contact
sports, may be linked to a greater risk
of chronic traumatic encephalopathy
(CTE), a form of dementia. CTE,
which was previously referred to as
“punch-drunk syndrome”, is a
progressive and fatal brain disease
associated with repeated TBIs.
Common symptoms of CTE are
memory loss and thinking problems,
confusion, sudden changes in
personality, and erratic behavior
including aggression, depression and
even suicidal thinking. Because CTE is
a relatively new area of exploration for
researchers and physicians,
formal clinical guidelines for
diagnosing and managing this
condition do not yet exist.
Several major research
initiatives are under way to
gain further insight into the
patterns of injury and brain
changes that may be
implicated in CTE, and to
develop new strategies for
prevention, diagnosis and
treatment.
Although there’s no known
strategy to reduce the possible
long-term risk of dementia
once you’ve experienced a
moderate to severe TBI, or
repeated mild traumatic brain
injuries, it’s important to
understand that not everyone
who experiences a head
injury develops dementia.
Just as age is a risk factor for
cardiovascular disease, not
every adult over the age of 65
will have a heart attack.
The Alzheimer’s Association’s
10 Ways to Love Your Brain
outlines key strategies for
minimizing the risk factors of
dementia: keeping physically
active, eating a balanced diet
and staying socially engaged
are some of the habits to
achieve maximum benefit for
your brain and body. These are
also important practices for
maintaining brain health after a
TBI. Fortunately, there are
places in our own community
that focus on these approaches
to enhance and preserve the
quality of life for those living
with brain injury.
The Alzheimer’s Association
is partnering with Jodi House
Brain Injury Support Center of
Santa Barbara to host a virtual
education program on
recognizing the signs of
Alzheimer’s. The educational
presentation will be followed
by an interactive discussion on
the overlap of symptoms in
dementia and brain injury and
what we can do to minimize
them. You can find out more
information and register at our
website, alz.org/CACentral.
KEEP ALERT
Anyone who experiences an impact to the
head and develops any symptoms of
traumatic brain injury should seek medical
attention, even if symptoms seem mild.
Call emergency services for anyone who’s
unconscious for more than a minute, or
who experiences seizures, repeated
vomiting or symptoms that seem to worsen
as time passes. Seek emergency care for
anyone whose head was injured during
ejection from a vehicle, who was struck by
a vehicle while on foot or who fell from a
height of more than three feet.
REDUCING RISK OF TBI FOR
OLDER ADULTS
1. Use a walker or other assistive device to
compensate for mobility problems, muscle
weakness or poor balance. Don’t worry
about cramping your style, they make some
VERY stylish mobility devices nowadays!
2. Have your vision checked regularly and
use glasses or contact lenses as prescribed
3. Work with your doctor to watch for
medication side effects or interactions
among drugs you’re taking that could alter
perception, balance or make you drowsy.
4. Avoid household hazards, such as
clutter, loose rugs or poor lighting.
5. Be a safe traveler: keep your vehicle in
good repair, follow the rules of the road and
buckle your seatbelt.
6. Protect your head: always wear a helmet
when biking, surfing or participating in any
activity where falling or crashing is a
possibility.