Volume 25 Issue 8 - January 17, 2014 PDF
Population-Based Study on Patients with Traumatic Brain Injury Suggests Increased Risk of Dementia
Hao-Kuang Wang1,2, Sheng-Hsiang Lin1, Pi-Shan Sung1,3, Ming-Hsiu Wu1,4, Kuo-Wei Hung1,5, Liang-Chao Wang1,6, Chih-Yuan Huang1,6, Kang Lu2, Han-Jung Chen2, Kuen-Jer Tsai1,*
1 Institute of Clinical Medicine, National Cheng Kung University, Tainan, Taiwan
2 Department of Neurosurgery, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
3 Department of Neurology, National Cheng Kung University Hospital, Tainan, Taiwan
4 Department of Neurology, Chi Mei Medical Centre, Liouying, Tainan, Taiwan
5 Department of Neurology, Yuan's General Hospital, Kaohsiung, Taiwan
6 Neurosurgical Service, Department of Surgery, National Cheng Kung University Hospital, Tainan, Taiwan
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Traumatic brain injury (TBI) is the leading cause of mortality and disability in young adults across the world, especially in Taiwan. Neurodegenerative diseases, including Alzheimer’s disease (AD), Parkinson’s disease (PD), and amyotrophic lateral sclerosis (ALS), have been frequently reported to develop in patients with TBI. However, the relationship between traumatic brain injury (TBI) and the risk of dementia remains controversial. In previous studies that stated TBI was not a significant risk factor for dementia, they had some problems like short observation time, clear history of prior TBI, or a definitive diagnosis of AD. The goal of our study was to determine whether TBI was associated with an increased risk and incidence of dementia by using the Longitudinal Health Insurance Database (LHID2000) in Taiwan.

This study was a retrospective cohort study and was designed to estimate and compare the risk of dementia in TBI and non-TBI individuals after TBI. We selected 44,925 patients receiving ambulatory or hospitalization care foe TBI and 224,625 non-TBI; patients were matched by sex, age, and year of index use of health care. Patients were younger than 15 years old as well as patients had admitted to the intensive care unit (ICU) are excluded. Each individual was studied for 5 years to identify the subsequent development of dementia. Data were analyzed by Cox proportional hazard regression. During the 5-year follow-up period, TBI was independently associated with a 1.68 times greater risk of dementia after adjusting for sociodemographic characteristics and selected comorbidities. The findings of this study suggest an increased risk of dementia among individuals with TBI. We suggest the need for more intensive medical monitoring and health education in individuals with a TBI.
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