Professor Jonathan Schott of UCL's Institute of Neurology said the research provides "perhaps the best evidence yet that traumatic brain injury is a risk factor for dementia", but said further work was required to differentiate types of injuries, such as sport-related concussions, and how they affect the brain.
"Severe TBI is particularly frequent in young people, and it is concerning that the risk of dementia is particular high in relatively young persons who suffer TBI", said Jakob Christensen, Associate Professor at Aarhus University Hospital in Denmark.
After adjusting for medical, neurological and psychiatric illnesses, they found that compared with people who had never had a T.B.I., those who had had any were at a 24 percent increased risk for dementia, and those who had had five or more had almost triple the risk. Whereas two-three traumatic brain injuries is associated with a 33 percent increase in dementia, four traumatic brain injuries is associated with about a 60 percent increase of risk.
The study also found that the younger a person was when they sustained the TBI, the higher their subsequent risk of developing dementia. There are about 10 million new dementia cases each year.
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Each year, more than 50 million people worldwide suffer a traumatic brain injury, which occurs when a bump or blow to the head disrupts normal brain function.
In total, 5.3 per cent of participants with dementia had a history of TBI compared with 4.7 per cent of those without the condition. The leading causes include falls, motor vehicle accidents and assaults. For example, individuals having a TBI in their 20s were 63% more likely to develop dementia about 30 years later compared to those who didn't sustain a TBI in their 20s (overall dementia rate 0.55 per 1000 person years vs 0.34 per 1000 person-years); whereas individuals sustaining a TBI in their 30s were 37% more likely to develop dementia 30 years later compared with those without a TBI in their 30s (1.67 per 1000 person-years vs 1.22 per 1000 person-years; figure 2). The mean age at first diagnosis of dementia was 80.7 years.
The researchers noted that while previous research has suggested a link between TBI, including concussion, and subsequent dementia, earlier studies have been limited in size and details, and have had short follow-up periods. TBI correlated with elevated dementia risk compared to individuals with a non-TBI fracture not involving the skull or spine (hazard ratio, 1.29).
The researchers note that the absolute risk remains low, but one must remain especially mindful nevertheless. "Our findings suggest that improved traumatic brain injury prevention programmes may have an opportunity to reduce the burden of dementia worldwide".