Persons with Alzheimer’s disease have a higher risk of head injuries

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AlzheimersPersons with Alzheimer’s disease have approximately 30% higher risk of head injuries, and 50% higher risk of traumatic brain injuries than persons without Alzheimer’s disease, a recent study from University of Eastern Finland and the Karolinska Institute, Sweden shows.

This is the first study that has assessed the incidence of head and traumatic brain injuries among persons with Alzheimer’s disease. Falls are the most common cause of head injuries in older adults, and persons with Alzheimer’s disease are known to have a higher risk of falling. The findings of this study highlight the importance of fall prevention, as head injuries can shorten the life expectancy and deteriorate a person’s functional capacity. For persons with Alzheimer disease, head injuries may lead to the loss of activities of daily living and independence, and to the need of residential care even at early stages of the disease.

This study was conducted in the nationwide register-based MEDALZ cohort which included all community-dwelling persons who received an Alzheimer’s disease diagnosis in Finland 2005-2011. From the overall cohort, 67,172 persons without a previous head injury were selected to the study. For comparison purposes, a matching person with neither Alzheimer’s disease nor a previous head injury was identified with respect to age, sex and university hospital district.

Abstract
Background: Injuries caused by falling are a major health concern among older population. For older people, falls are the leading cause of head injuries; especially, persons with cognitive disorders have an increased risk of falling.
Objective: To compare the incidence of head injury and traumatic brain injury (TBI) among persons with Alzheimer’s disease (AD) with persons without AD.
Methods: This register-based study was conducted on a nationwide cohort, which includes all community-dwelling persons diagnosed with AD in Finland in 2005–2011. Persons with previous head injuries were excluded, leaving 67 172 persons with AD. For each person with AD, a matching person without AD and previous head injury were identified with respect to age, sex and university hospital district. The Cox proportional hazard model and competing risk analyses were used to estimate HR for head injury and TBI.
Results: Persons with AD had 1.34-fold (95% CI 1.29 to 1.40) risk of head injuries and 1.49-fold (95% CI 1.40 to 1.59) risk of TBIs after accounting for competing risks of death and full adjustment by socioeconomic status, drug use and comorbidities.
Conclusion: Persons with AD are more likely to have a head injury or TBI incident than persons without AD.

Authors
Sarianna Ilmaniemi, Heidi Taipale, Antti Tanskanen, Jari Tiihonen, Sirpa Hartikainen, Anna-Maija Tolppanen

University of Eastern Finland material
Journal of Epidemiology and Community Health abstract


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