The results showed that fewer than 5 percent of people who suffered a traumatic brain injury developed dementia, but that the risk of dementia is highest in the first six months after a severe brain injury and increases along with the number of events.
The risk increases by 24 percent, the researchers write in the journalThe Lancet Psychiatry, and is relative to the number and severity of brain injuries.
Compared with individuals without a history of TBI, the risk of dementia after the age of 50 increased consistently with the number of TBIs-22% higher risk with one TBI (4.6% participants with dementia vs 4.1% of participants without dementia), 33% higher with two (0.5% vs 0.4%) or three TBIs (0.1% vs 0.1%), 61% higher with 4 TBIs (˂0.1% vs ˂0.1%), and almost three times the likelihood of dementia with five or more TBIs (˂0.1% vs ˂0.1%). But the risk increased significantly for people with multiple brain injuries, and for people who were in their 20s at the time for their first brain injury.
Despite the size of the studies, they won't settle scientific questions - or social debate - about brain injuries from sports, war, vehicle crashes or domestic violence. Similarly, more research needs to be done on how to reduce the risks in younger patients, who are also much more likely to develop dementia.
Researchers analyzed 36 years of health records of 2.8 million people in Denmark, where a national health system makes it possible to explore connections in a far-reaching way.
A traumatic brain injury can be caused by a fall, a traffic accident, a sports accident or a violent attack.
But the team said the absolute risk to an individual remained low. For example, a person who sustained a TBI in their 20s was 63% more likely to develop dementia 30 years later compared to someone who did not sustain such an injury in their 20s. People with a history of TBI had a higher fully-adjusted risk of all-cause dementia (hazard ratio, 1.24) compared to those without a history of TBI; the risk of Alzheimer's disease was also increased (hazard ratio, 1.16).
Researchers found that age plays a factor: "the younger younger a person was when sustaining a TBI, the higher the HRs [hazard ratios] for dementia when stratified by time since TBI".
The association between TBI and dementia held true even when comparing people with a history of TBI to those with non-TBI fractures not involving the skull or spine.
A single TBI increased the risk by more than a third. Above all, those affected should try to avoid further traumatic brain injury.
One possible weakness of the study was that it looked at people from a single country with a "fairly similar ethnic population", said the authors - meaning its findings may not apply to people of other ethnic groups in other countries.
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