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September 2018

Risk of Dementia Outcomes Associated With Traumatic Brain Injury During Military Service

Author Affiliations
  • 1Department of Neurology, Uniformed Services University of the Health Services, Bethesda, Maryland
  • 2National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland
  • 3Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia
JAMA Neurol. 2018;75(9):1043-1044. doi:10.1001/jamaneurol.2018.0347

The chronic effects of traumatic brain injury (TBI), particularly dementia and related neurodegenerative disorders in military veterans, have become an intense research focus. It has long been recognized that moderate to severe TBI in early life or midlife is associated with increased risk of late-life dementia.1 The association between severe TBI and dementia in civilians has relied on epidemiology of patients with remote TBI and late-onset Alzheimer disease (AD) (usually after age 65 years) and other dementias. Epidemiologic studies have had mixed results of risk of developing dementia after mild TBI (mTBI).2-6 Earlier community-based and population-based studies found no increased association between mTBI with loss of consciousness (LOC) and late-onset dementia or AD.5,6 More recent studies have shown an association between TBI and earlier-onset dementia, suggesting an association between number and severity of head injuries and increasing dementia risk.3,4 Discordance across epidemiologic studies likely results from methodological differences as well as diagnostic uncertainty of both TBI and dementia, compounded by the current absence of validated clinical criteria for TBI-associated dementia.

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