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Traumatic brain injury may increase risk of young-onset dementia.
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Ann Neurol 2014 Feb;
Authors: Raquel C Gardner, Kristine Yaffe
Since the first description of dementia pugilistica in 1928, traumatic brain injury (TBI) has emerged as an important risk factor for dementia in many, but not all, large epidemiological studies. Whether TBI is associated with increased risk for young-onset dementia (YOD), defined as dementia before age 65, has not been thoroughly investigated. In this issue of Annals of Neurology, Nordstrom et al report the results of a large Swedish epidemiological study using administrative health data to assess risk of YOD after TBI in more than 800,000 men (more than 45,000 with TBI) who were followed for more than three decades. They report a strong dose-dependent association between TBI and all-cause YOD that remained significant even after multivariable adjustment. A dementia subtype analysis was also performed, but was underpowered, and thus should be interpreted with caution. The findings of this study are consistent with mounting basic and translational evidence for a causal link between TBI and the triggering of a neurodegenerative cascade involving multiple proteins implicated in a range of neurodegenerative diseases, including chronic traumatic encephalopathy, Alzheimer's disease, frontotemporal dementia, and Parkinson's disease. There are an estimated 1.4 million emergency department visits for TBI annually in the United States among patients under the age of 65. Thus, the identification of an association between TBI and YOD may have important public health implications and warrants further research in large prospective longitudinal studies ending in autopsy, which will inform development of diagnostic, treatment, and prevention strategies. ANN NEUROL 2014. © 2014 American Neurological Association.
PMID: 24550062 [PubMed - as supplied by publisher]