Risk for Dementia: Head Trauma

Traumatic brain injury (TBI) describes situations in which an external force, such as a fall or a blow to blow to the head causes extreme pain that is often accompanied by a short or a long period of unconsciousness. People who experience multiple traumatic brain injuries are at high risk of developing dementia later in life. (Note 1)

However, the key phrase “increase risk for” means that TBIs do not cause dementia but do increase the likelihood of having dementia sometime in the future.

In a recent and extensive review of the research literature, Sharan Shively, MD, Ph.D., and colleagues report that a history of moderate and severe TBIs increases the risk of having late-life dementia 2 - to - 4 times that of people who have never experienced a traumatic brain injury. (Note 2) To come to this conclusion, Shively and colleagues reference earlier studies that compare the presence or absence of later-in-life dementia in people who suffered concussions of sufficient severity to cause loss of consciousness to individuals who report never having experienced that degree of head trauma. (Note 2) People who experience multiple traumatic brain injuries are at high risk of developing dementia later in life. (Note 1)

The syndrome, associated with having multiple traumatic brain injuries was originally described in 1928. Called dementia pugilistica or “punch drunk” was first observed in boxers who suffered repeated knock-outs. (Note 3) It took many more years of casual observation before medical researchers linked a history of repeated sports and military-related head injuries, to the onset of dementia symptoms later in life. The condition, chronic traumatic encephalopathy, (CTE) now receives considerable coverage in the public media.

Signs and symptoms of CTE usually begin eight to 10 years after the traumatic brain injuries and include difficulty in thinking, impulsive behavior, memory loss, substance abuse, as well as suicidal thoughts or behavior. (Note 4) Over time, the changes caused by CTE worsen as well as progress to aggressive behaviors, tremor, and speech and language difficulties. (Note 4) More than one-third of people with CTE eventually show signs of other degenerative brain diseases such as dementia and Parkinson disease. (Note 3)

Undoubtedly, ongoing and future research will improve our understanding of traumatic brain injuries and their relationship to later-in-life dementia. In the meantime, you can reduce the likelihood of receiving a head injury by trip-proofing your home, being observant of hazards such as low tree branches and open kitchen cabinet doors, as well as by wearing a helmet to prevent sports-related injuries.

Even if you have experienced multiple head injuries, you may be able to reduce your overall risk of developing dementia by implementing lifestyle changes that include such things as maintaining a healthy weight, eating a heart-healthy diet, as well as participation in an assortment of physical, social and mental activities.

Notes:
1. Alzheimer’s: Can a head injury increase my risk?”, http://www.mayoclinic.org/alzheimers-disease/expert-answers/faq-20057837 (accessed March 21, 2016)
2. Shively et al, “Dementia Resulting from Traumatic Brain Injury” https://www.researchgate.net/publication/229011632_Dementia_Resulting_From_Traumatic_Brain_Injury_What_Is_the_Pathology (accessed March 22, 2016)
3. What Is Chronic Traumatic Encephalopathy?, http://www.brainline.org/content/2010/12/what-is-chronic-traumatic-encephalopathy.html (accessed April 7, 2016)
4. Chronic Traumatic Encephalopathy, http://www.mayoclinic.org/diseases-conditions/chronic-traumatic-encephalopathy/basics/definition/con-20113581 (accessed April 6, 2016)

Contributor: Janet Yagoda Shagam, Ph.D., is a freelance medical and science writer and the author of “An Unintended Journey: A Caregiver's Guide to Dementia.” Available through Amazon.

The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse or guarantee products, comments, suggestions, links, or other forms of the content contained within blog posts that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice. Please consult your doctor. www.DementiaSociety.org

Keeping the Home Safe for Those Living With Dementia

Those living with Dementia often become less able to manage around the house as their condition progresses. For example, they may forget to turn off the oven or the water, how to use the phone during an emergency, which things around the house are dangerous, and where things are in their own home.

Prevention is key. It is more effective to change the person’s surroundings — for example, to remove dangerous items — than to try to change behaviors. Changing the home environment can give the person more freedom to move around independently and safely.

The National Institute on Aging provides these tips on creating a Dementia-safe home.

Simplify the Home

Get rid of clutter, too much furniture, exposed cords, and small throw rugs – anything that could lead to falls and injuries. Installing non-skid strips on floors can help. Shoes and slippers with good traction also help the person move around safely.

Minimize Danger by Addressing the Five Senses

Those living with Dementia may no longer accurately interpret what they see. Any objects – curtains or bedspreads, for example – that have busy patterns can cause confusion. Mark the edges of steps with brightly colored tape so people can see the steps as they go up or downstairs. Limit the size and number of mirrors, as they also can cause confusion.

People with Dementia may experience loss of touch or sensation, or may no longer be able to relate to feelings of heat, cold, or discomfort. Lower hot water heaters to 120 degrees to prevent burns. Put signs near the oven, toaster, iron, and other things that get hot. The sign could say, "Stop!" or "Don't Touch — Very Hot!" The person with Dementia should not use appliances without supervision.

A loss of or decrease in smell is common in people with Dementia. Check smoke detectors to make sure they are working properly, since those with Dementia may not be able to smell smoke. Also, check on refrigerated foods to make sure they have not spoiled.

People with Dementia may not taste as well as before. They also may place dangerous or inappropriate things in their mouths.  Put away or lock up things like toothpaste, lotions, shampoos, rubbing alcohol, soap, perfume, or laundry detergent pods. They may look and smell like food to a person with Dementia. Keep the Poison Control Center number (1-800-222-1222) by the phone.

Those living with Dementia may also lose their ability to interpret what they hear – even if they have normal hearing. This may result in confusion or over-stimulation. Don't play the TV or music too loudly, and don't play them at the same time. Loud music or too many different sounds may be too much for the person with Dementia to handle.

Click here for more on home safety and those living with some form of Dementia.

Source: National Institute on Aging

The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse or guarantee products, comments, suggestions, links, or other forms of the content contained within blog posts that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice. Please consult your doctor.