Dementia and traumatic brain injury

Traumatic brain injury (TBI) affects millions of people around the world. It occurs when an outside force hits the head hard enough that the brain moves, resulting in negative effects to brain function.1 According to the CDC, the rates of hospitalizations and deaths related to TBI have increased between 2001-2010.2 The two leading causes of TBI are falls and motor vehicle accidents, and most people who are affected are 65 years and older.2 Due to the increased rates of TBI, there are many people living with disabilities or neurological impairments related to their injuries. One such negative outcome is dementia.

Dementia is a neurological disorder that affects a person’s normal, day-to-day functioning. The disorder causes a progressive loss of cognitive function that can lead to memory impairments, inability to plan, or changes in behavior.1 These symptoms can overlap significantly with TBI symptoms, so it is important to differentiate the two. To diagnose TBI, clinicians use neurological exams and imaging techniques such as computer tomography (CT) and magnetic resonance imaging (MRI). Without imaging the head, physicians can diagnose milder forms of TBI when a person reports symptoms such as headache, dizziness, fatigue, or change in sleep patterns.4 More severe TBIs can cause nausea or vomiting, seizures, slurred speech, loss of coordination, and confusion.4 Much like TBI, symptoms of dementia can also range from mild to severe. The earliest symptom of dementia is usually difficulty recalling recent events, and other mild symptoms include misplacing items, mood and personality changes, or getting lost in a familiar place.5 People whose dementia is more severe will likely have mood or personality changes, trouble recognizing family members, or difficulty speaking.5

The effects of dementia can be devastating. As a result, people who sustain TBI should follow doctor-prescribed treatment regimens to reduce the risk of developing injury-related neurological disorders. Many mild TBI symptoms can be relieved by resting and taking over-the-counter medications,4 and a follow-up visit with a healthcare provider is recommended to confirm recovery progress and discuss any new or persistent symptoms. For more severe cases of TBI, patients are encouraged to begin cognitive rehabilitation therapy (CRT) after leaving the hospital. This intervention is an individualized training program that can help individuals regain or protect brain function.4

Clinicians also encourage individuals to remember that, unlike other neurological disorders, TBI is preventable. The CDC recommends the following to prevent TBIs:

  • Always wear a seatbelt when in a motor vehicle
  • Wear a helmet when appropriate and ensure the size is correct
  • Install window guards and stair safety gates at home for young children
  • Never drive under the influence of drug or alcohol
  • Install handrails on stairways
  • Ensure children’s playgrounds are made of shock-absorbing material like hardwood mulch or sand

Following these guidelines can lower the risk of suffering from a TBI and further developing a neurological disorder, such as dementia.4

References

  1. Ramalho, J., & Castillo, M. (2015). Dementia resulting from traumatic brain injury. Dementia & Neuropsychologia, 9(4), 356–368. doi: 10.1590/1980-57642015dn94000356
  2. Galgano, M., Toshkezi, G., Qiu, X., Russell, T., Chin, L., & Zhao, L. R. (2017). Traumatic Brain Injury: Current Treatment Strategies and Future Endeavors. Cell transplantation, 26(7), 1118–1130. doi:10.1177/0963689717714102
  3. Moreira, S. V., Justi, F. R. D. R., & Moreira, M. (2018). Can musical intervention improve memory in Alzheimer’s patients? Evidence from a systematic review. Dementia & Neuropsychologia, 12(2), 133–142. doi: 10.1590/1980-57642018dn12-020005
  4. National Institute of Neurological Disorders and Stroke (2018). Traumatic brain injury information page. https://www.ninds.nih.gov/disorders/all-disorders/traumatic-brain-injury-information-page.
  5. Jin, J. (2015). Alzheimer Disease. Jama, 313(14), 1488. doi: 10.1001/jama.2015.2852
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