New Study Examines the Burden of Dementia Among Young Population After Traumatic Brain Injury

Boston, MA – A new study in Neurosurgery titled “The Impact of Age and Severity on Dementia After Traumatic Brain Injury: A Comparison Study” examined the incidence of dementia among patient population with brain injury. Up to this point, relatively few studies have evaluated the associations between traumatic brain injury and dementia onset in patients under the age of 55. This retrospective study examined the risk of dementia using orthopedic trauma patients without head injury as control subjects and investigated the impact of age and brain injury severity in about 25,000 patients with traumatic brain injury from 2000 to 2018.

“This study shows the importance of screening for dementia after traumatic brain injury, regardless of age or injury severity. We found an increased risk of dementia, even in the middle-aged population with milder injuries. This particular population has largely been overlooked in dementia studies and our hope is that these results to spur proactive long-term monitoring, and advance the standard of care, and eventually improving outcomes,” said the principal investigator, Saef Izzy, MD, Assistant Professor of Neurology at Brigham and Women’s Hospital and Harvard Medical School.

“It is vital we challenge our previous assumptions on traumatic brain injury in younger populations. The data in the study demonstrates that we should explore interventions to support the under 55 TBI population to address dementia earlier and improve their long-term quality of life,” said co-author Ross Zafonte, DO, President, Spaulding Rehabilitation, Chair of the Harvard Medical School Department of Physical Medicine and Rehabilitation at Spaulding, Earle P. and Ida S. Charlton Professor of Physical Medicine and Rehabilitation, Harvard Medical School.

Researchers studied data derived from the Mass General Brigham Research Patient Data Registry, which captures all inpatient, outpatient, and emergency department encounters from a large regional network of hospitals that includes level 1 trauma care centers, community hospitals, and inpatient rehabilitation facilities. The study team found a higher incidence rate of dementia after both mild and moderate-severe traumatic brain injury than controls, even in the youngest group of 45–54 years. Mild TBI patients had higher incidence of dementia (9%) than moderate/severe TBI (5.4%), with lower 10-yr mortality (20% vs 31%; P < .001). Cardiovascular risk factors such as hypertension, hyperlipidemia and neuropsychiatric comorbidities were significant predictors of dementia. These results expand the literature by demonstrating a significantly increased risk of dementia in a middle-aged population with milder forms of brain injury. Since these patients are more likely to be overlooked in dementia screening, these findings highlight the need for dementia monitoring after TBI in all adults, regardless of age or severity. Future studies to assess the role of post-TBI comorbidities in predicting the onset of dementia are also warranted.

This research was supported by the Football Players Health Study at Harvard University which is in turn sponsored by the National Football League Players Association.

About Spaulding Rehabilitation

A member of the Mass General Brigham Health System, Spaulding Rehabilitation includes Spaulding Rehabilitation Hospital, with a main campus in Charlestown the 3rd ranked rehabilitation hospital in the country by U.S. News & World Report, along with Spaulding Rehabilitation Hospital Cape Cod, Spaulding Hospital Cambridge, Spaulding Nursing and Therapy Center Brighton, and over 25 outpatient sites throughout Eastern Massachusetts. An acclaimed teaching hospital of Harvard Medical School and home to the Department of Physical Medicine and Rehabilitation, Spaulding is recognized as the top residency program in the U.S. in the 2020/2021 Doximity Residency Navigator. Spaulding also was recognized by the 2021 Disability Equality Index as a “Best Places to Work for Disability Inclusion.” For more information, visit www.spauldingrehab.org.

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