Dementia and brain injury

Dementia is a broad term used to describe a range of symptoms, the most well known of these being a gradual loss of a person’s memory. Other symptoms can include gradual deterioration in speech, motor skills, thinking and planning, and the ability to carry out daily tasks. People with dementia can lose their ability to control their behaviour and may at times be socially inappropriate or unaware. The disease is progressive, meaning that symptoms become worse over time. Towards the later stages of the disease, people require full-time care from family or staff in a nursing home. Dementia is a terminal disease, and despite the best efforts of our medical researchers, there is currently no cure. 

There are a number of different types of dementia, the most common being Alzheimer’s disease, and others including vascular dementia (usually related to stroke), Parkinson’s disease dementia, alcohol-related dementia, and Lewy Body Syndrome. While the risk of dementia increases with age, it is not a normal or natural part of ageing. Although rare, people in their 50s, 40s and even 30s can be diagnosed with ‘younger onset’ dementia.

Research has shown that people who have had a moderate to severe brain injury are more likely to develop dementia in later life. The pattern of changes seen in the brain following a moderate to severe brain injury can appear similar to those changes seen in Alzheimer’s disease. It is not as clear whether there is an increased risk of dementia for those who have had a mild ABI, such as a brief concussion. 

Repeated, mild ABIs, such as those experienced by professional sports people like boxers and footballers, are related to a condition similar to dementia known as Chronic Traumatic Encephalopathy (CTE). This condition is also seen amongst war veterans who have experienced repeated, mild head traumas. CTE has particular symptoms such as changes in mood, thinking, behaviour, and difficulties with balance and motor skills.

Researchers at the World Health Organisation (WHO) have found that a person is more likely to develop Alzheimer’s disease if they have diabetes, high blood pressure or depression. A person is also at greater risk if they are obese, don’t exercise regularly, if they smoke, or if they have low levels of education. Other types of dementia have other risk factors: for example, heavy drinkers are more likely to develop alcohol-related dementia. 

Based on these risk factors, there are five important steps that we can take to reduce our risk of dementia: 

Look after your heart – Have your blood pressure, cholesterol, blood sugar levels and weight checked regularly by your doctor. Avoid smoking. 

Be physically active – National Physical Activity Guidelines recommend at least 30 minutes of moderate-intensity exercise (e.g. walking, dancing, swimming, cycling) on most, if not every day. 

Mentally challenge your brain – For example, learn a new skill, enrol in an educational course, read about interesting or novel topics, or have a regular, engaging hobby. 

Follow a healthy diet – Eat a variety of foods, including two serves of fruit and five serves of vegetables per day. Limit your alcohol consumption to no more than two standard drinks on any given day. 

Enjoy a social activity – Help to keep your brain active by organising regular social outings with friends and family, joining a community or volunteer group or having a regular social leisure activity (such as cards).  

If you are concerned about your memory or that of someone close to you, it is important to speak to a doctor. A doctor will be able to listen to your concerns and investigate a range of possible causes of memory difficulties. An early diagnosis of dementia ensures that a person has access to support, information and treatment options. It also gives people the opportunity to help plan their future care, including financial and lifestyle wishes. When visiting your doctor, it is helpful to write down your concerns before the appointment, and consider bringing along a close friend or family member for support.  

More information on how to maintain brain, heart and body health can be found at Alzheimer’s Australia’s website. 

Thanks to Jeanette Van Luyn from Alzheimer’s Australia (Qld) for contributing this article. Visit Alzheimer’s Australia(Qld)’s website for a range of information and fact sheets for people with dementia, those who care for them, and the general community.

Australian Institute of Health and Welfare (2012). Dementia in Australia. AIHW: Canberra. 

Shrively, S.; Scher, A.I.; Perl, D.P.; Diaz-Arrastia, R. (2012). Dementia resulting from traumatic brain injury: What is the pathology? Archives of Neurology, 69(10), 1245-1251. 

World Health Organisation (WHO). (2012). Dementia: A Public Health Priority. WHO: Albany, NY, USA. 

Sampson, E.L.; Warren, J.D.; Rossor, M.N. (2004). Young-onset dementia. Postgraduate Medical Journal, 80, 125-139. 

McKee, A.C.; et al. (2010). Chronic traumatic encephalopathy in athletes: progressive tauopathy following repetitive head injury. Journal of Neuropathology and Experimental Neurology, 68(7), 709-735.