A recent study reveals that people with Alzheimer's disease have an approximately 30 percent higher risk of head injuries and 50 percent higher risk of traumatic brain injuries than persons without Alzheimer's disease. The study - published in Journal of Epidemiology and Community Health - is the first to assess the incidence of head and traumatic brain injuries among persons with Alzheimer's disease. Falls are the most common cause of head injuries in older adults, and people with Alzheimer's disease are known to have a higher risk of falling. The findings of this study highlight the importance of fall prevention, as head injuries can shorten the life expectancy and deteriorate a person's functional capacity. For those with Alzheimer’s disease, head injuries may lead to the loss of activities of daily living and independence, and to the need of residential care even at early stages of the disease.
The University of Eastern Finland study was conducted in the nationwide register-based MEDALZ cohort which included all community-dwelling persons who received an Alzheimer's disease diagnosis in Finland 2005-2011. From the overall cohort, 67,172 persons without a previous head injury were selected to the study. For comparison purposes, a matching person with neither Alzheimer's disease nor a previous head injury was identified with respect to age, sex and university hospital district.
Are Mental Health Disorders Common Following Mild Head Injury?
Approximately one in five individuals may experience mental health symptoms up to six months after mild traumatic brain injury (mTBI), suggesting the importance of follow-up care for these patients, a study reveals. Scientists also identified factors that may increase the risk of developing post-traumatic stress disorder (PTSD) and/or major depressive disorder following mild mTBI or concussion through analysis of the Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) study cohort. The study is part of the NIH-funded TRACK-TBI initiative, which is a large, long-term study of patients treated in the emergency department for mTBI. "Mental health disorders after concussion have been studied primarily in military populations, and not much is known about these outcomes in civilians," says Patrick Bellgowan, Ph.D., NINDS program director. "These results may help guide follow-up care and suggest that doctors may need to pay particular attention to the mental state of patients many months after injury."
In the study - published in JAMA Psychiatry - Murray B. Stein, M.D., M.P.H., professor at the University of California San Diego, and his colleagues investigated mental health outcomes in 1,155 people who had experienced a mild TBI and were treated in the emergency department. At three, six, and 12 months after injury, study participants completed various questionnaires related to PTSD and major depressive disorder. For a comparison group, the researchers also surveyed individuals who had experienced orthopedic traumatic injuries, such as broken legs, but did not have a head injury.
The results showed that at three and six months following injury, people who had experienced mTBI were more likely than orthopedic trauma patients to report symptoms of PTSD and/or major depressive disorder. For example, three months after injury, 20 percent of mTBI patients reported mental health symptoms compared to 8.7 percent of orthopedic trauma patients. At six months after injury, mental health symptoms were reported by 21.2 percent of people who had experienced a head injury and 12.1 percent of orthopedic trauma patients.
Follow-Up Care Crucial
They also used the data to determine risk factors for PTSD and major depressive disorder after mTBI. The findings revealed that lower levels of education, self-identifying as African-American, and having a history of mental illness increased risk. In addition, if the head injury was caused by an assault or other violent attack, that increased the risk of developing PTSD, but not major depressive disorder. However, risk of mental health symptoms was not associated with other injury-related occurrences such as duration of loss of consciousness or posttraumatic amnesia. "Contrary to common assumptions, mild head injuries can cause long-term effects,” Stein continued. “These findings suggest that follow-up care after head injury, even for mild cases, is crucial, especially for patients showing risk factors for PTSD or depression."
Why Head Injuries Are So Complex
In recent years, it has become exceedingly discussed how head injuries are complicated and complex for a number of reasons. Concussions used to be treated much differently than they are now, especially in the case of professional sports. There is a study that was conducted by Stanford University that verifies just how complex the topic really has become over the years with emerging research at the forefront.
A concussion is something that occurs when an area deep inside the brain shakes more intensively and rapidly than other surrounding areas of the brain. Due to the complexity of the brain, this didn't necessarily seem very worrisome in terms of long-term effects even 10 years ago. Now with the symptoms that many football players and other athletes that suffer multiple concussions are facing, it has become very troubling and the topic of many conversations.
The study also found that due to the mechanical complexity of the brain, differentiating between those dangerous bumps, spins and blows versus those that aren't so serious or won't lead to the likelihood of injury is difficult. “Concussion is a silent epidemic that is affecting millions of people,” says post doctoral fellow Mehmet Kurt. “What we were trying to do is understand the biomechanics of the brain during an impact.”
In a previous study, 31 college football players donned special mouth guards that were able to record how a player's head would move during specific states of impact. They were then going to use this data to study exactly how and why a concussion is the result of some hits and not others. The data was able to conclusively show that the key difference between what impacts the brain and leads to concussions is when the brain actually shakes. Every hit does not result in a shake of the brain.
During a brain injury case, the way that this is differentiated is even more complex. There is a specific area deep within the brain called the corpus callosum, which shakes more rapidly than the surrounding areas of the brain and puts too much strain on those tissues. This tissue damage can cause long-term issues that are typically seen in those with multiple concussions - sleep disturbances, hallucinations, mental health lapses and so much more. These injuries can completely change the personality and the outlook of sufferers.
It is also worth noting that many of those first concussions can heal adequately on their own but that the first concussion makes the brain even more susceptible to suffering from an additional brain injury. This is way it's so essential that players get removed from games and tended to quickly as soon as the hit happens and get screened for a concussion. The brain is in a terribly fragile state at that time and needs immediate rest.
One researcher says that to design better helmets with specified technology will help give an even better, more expansive look into what is really happening and what decisions are being made to protect players’ health and potentially their lives.
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Lisa S. Jones is a certified nurse, nutritionist, fitness coach and health expert. Her training credentials include a B.Sc. in Nursing from California State University in 2013 and Youth Nutrition Specialist Certification from the American Fitness Professionals and Associates in 2015. In 2017, she also received Holistic Nutrition Certification from the American Fitness Professionals and Associates.