A bump to the head can sometimes change a person’s life forever. Traumatic brain injury, often called TBI, happens when a sudden blow or jolt damages the brain.
It can occur after a fall, a car crash, a sports injury, or another accident.
Some brain injuries are mild and cause symptoms such as headaches, dizziness, and confusion that improve over time.
Others can lead to long-term physical and mental problems. As people get older, the risk of experiencing a traumatic brain injury increases, mainly because older adults are more likely to fall.
For many years, scientists have known that a traumatic brain injury can increase the risk of developing certain brain disorders later in life.
Studies have linked TBI to conditions such as stroke, dementia, epilepsy, and Parkinson’s disease.
However, researchers have recently begun asking a different question. Instead of only looking at how a brain injury may lead to disease, they wondered whether these neurological conditions could themselves increase the chance of suffering a brain injury.
To explore this question, researchers studied older military veterans in the United States. The findings were published in the journal Neurology. The study was led by Dr. Carrie Peltz from the San Francisco Veterans Affairs Health Care System in California.
The research team examined medical records from 13,801 veterans who had recently experienced a traumatic brain injury. The average age of these veterans was 78 years. The scientists compared them with 41,403 veterans of similar ages who had not experienced a recent brain injury.
The researchers reviewed their health records for one year before and one year after the injury, or during a similar time period for the comparison group. People who had already been diagnosed with stroke, dementia, epilepsy, or Parkinson’s disease before the study period were not included.
The results were striking. Older adults who had recently suffered a traumatic brain injury were three to four times more likely to have been diagnosed with one of the four neurological conditions during the previous year compared with those who had not experienced a brain injury.
After accounting for factors such as diabetes, smoking, and a previous heart attack, the researchers found that people with TBI were four times more likely to have recently been diagnosed with epilepsy and three times more likely to have been diagnosed with stroke, dementia, or Parkinson’s disease.
The scientists also looked at what happened after a brain injury. They found that people who had suffered a TBI were twice as likely to develop stroke or epilepsy afterward compared with before the injury.
They were also 24 percent more likely to develop dementia. The risk of Parkinson’s disease did not appear to rise during the study period, although the researchers believe this may be because the follow-up period was relatively short.
The findings suggest that the relationship between brain injury and neurological disease may work in both directions. Conditions such as dementia, stroke, epilepsy, and Parkinson’s disease can affect balance, movement, coordination, and thinking abilities.
People living with these disorders may be more likely to fall, which is the leading cause of traumatic brain injury among older adults.
The researchers believe that older adults diagnosed with neurological conditions should be assessed for their risk of falling as soon as possible. Simple measures may make a meaningful difference.
Strength and balance exercises, physical therapy, occupational therapy, home modifications such as installing grab bars, removing tripping hazards, and reviewing medications have all been shown to reduce the risk of falls among older adults.
The study has several limitations. People who died within a year after a severe brain injury were not included because the study required one year of follow-up information.
At the same time, individuals with very mild brain injuries who did not seek medical attention were also left out. In addition, because all participants were military veterans, the findings may not apply equally to the general population.
Overall, the study offers an important new way of thinking about brain health in older age. Rather than viewing traumatic brain injury only as a cause of neurological disease, the findings suggest that some brain diseases may also increase the risk of suffering a brain injury.
The research highlights the importance of preventing falls and closely monitoring older adults who develop neurological conditions.
Although the study cannot prove cause and effect, it points to a potentially harmful cycle in which brain diseases and brain injuries may increase the risk of one another. Breaking this cycle through fall prevention and early intervention could help protect the health and independence of many older people.
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