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A Massive Study Of Veterans Reveals That Even 'Mild' Traumatic Brain Injuries Have Major Consequences
Mild traumatic brain injury may sound like an oxymoron, along the lines of “jumbo shrimp” or “random order.” But a new study shows that mild TBIs can have serious consequences for military veterans by raising their risk of dementia.
Researchers who examined the medical records of more than 350,000 Americans who served during the wars in Iraq and Afghanistan found that men and women who experienced at least one mild TBI were more than twice as likely as their uninjured peers to develop dementia after they retired from the military.
The finding was published Monday in the journal JAMA Neurology.
Experts already knew that moderate and severe traumatic brain injuries were linked with an increased risk of dementia and Alzheimer’s disease, as well as an earlier onset of these conditions. But whether mild TBIs pose risks as well has been unclear.
But the question is important because 15 percent to 20 percent of veterans who participated in Operation Enduring Freedom and Operation Iraqi Freedom had at least one mild TBI, typically through exposure to a shock wave that follows an explosion. Suffering multiple mild TBIs was not uncommon.
A team led by Deborah Barnes, a researcher with the San Francisco Veterans Affairs Health Care System and the University of California at San Francisco, hoped to gain some insight by casting a very wide net.
The team members scoured two large government databases to identify every patient treated by the Veterans Health Administration who was diagnosed with any kind of TBI during a 13-year period between 2001 and 2014. They found 178,779 such patients.
For 10 percent of these veterans, the most severe instance of traumatic brain injury was a mild TBI without any loss of consciousness. Another 13 percent had a mild TBI that did cause them to lose consciousness for no more than 30 minutes. In addition, nearly 31 percent of the veterans were diagnosed with mild TBI, but their medical records did not say whether they had lost consciousness as a result.
The remaining 46 percent of veterans had a TBI that was classified as moderate or severe.
All of these patients were matched with another veteran who was treated by the VHA but did not have a TBI. These 178,779 patients served as controls.
In the control group, 2.6 percent of veterans went on to be diagnosed with dementia. So were 6.1 percent of the veterans with a history of TBI.
The more serious a veteran’s brain injury, the greater the risk that he or she would subsequently develop dementia.
The unadjusted cumulative incidence of dementia (age at dementia diagnosis) is shown as a function of TBI severityJAMA Neurology
After accounting for factors like age, medical history and psychiatric conditions that could affect the results, the researchers found that those who experienced a mild TBI without losing consciousness were 2.36 times more likely to develop dementia during the study period than those in the control group.
The risk of dementia was 2.51 times greater for veterans with mild TBI who did lose consciousness for a short period of time, and it was 3.19 times greater for veterans with mild TBI whose records didn’t indicate whether they had lost consciousness or not.
Barnes and her team also calculated that veterans with moderate or severe TBI were nearly four times more likely than their uninjured peers to develop dementia during the study period. That was consistent with previous studies, they wrote.
On average, the time between entering the study and being diagnosed with dementia was 3.6 years for those who had suffered a TBI, compared with 4.8 years for those who hadn’t.
It’s not entirely clear why the damage caused by a traumatic brain injury would make someone more susceptible to dementia, the study authors noted. Perhaps the inflammation and loss of white matter that follow a TBI create a more fertile environment for the amyloid beta plaques and neurofibrillary tangles associated with dementia, they wrote.
The researchers cautioned that their findings might not apply to the public at large, since their study was based solely on military veterans who had served since 2001. Even so, they wrote, the results strengthen the case that mild TBIs can have serious consequences.
A pair of neurologists agreed in an editorial that accompanied the study.
“This study provides the best information to date that military veterans are at risk for dementia as a consequence of injuries sustained during their service to the United States,” wrote Dr. Kimbra Kenney of the U.S. Uniformed Services University and Dr. Ramon Diaz-Arrastia of the University of Pennsylvania’s Traumatic Brain Injury Clinical Research Center.
©2018 Los Angeles Times. Distributed by Tribune Content Agency, LLC.
North Korea threatens to resume nuclear weapons and ICBM tests if US-South Korea military exercises proceed
SEOUL (Reuters) - The United States looks set to break a promise not to hold military exercises with South Korea, putting talks aimed at getting North Korea to abandon its nuclear weapons at risk, the North Korean Foreign Ministry said on Tuesday.
The United States' pattern of "unilaterally reneging on its commitments" is leading Pyongyang to reconsider its own commitments to discontinue tests of nuclear weapons and intercontinental ballistic missiles (ICBMs), the ministry said in a pair of statements released through state news agency KCNA.
Customs and Border Patrol denied a Marine vet entry into the US for his a scheduled citizenship interview
A deported Marine Corps veteran who has been unable to come back to the U.S. for more than a decade was denied entry to the country Monday morning when he asked to be let in for a scheduled citizenship interview.
Roman Sabal, 58, originally from Belize, came to the San Ysidro Port of Entry around 7:30 on Monday morning with an attorney to ask for "parole" to attend his naturalization interview scheduled for a little before noon in downtown San Diego. Border officials have the authority to temporarily allow people into the country on parole for "humanitarian or significant public benefit" reasons.
Navy Secretary Richard Spencer took the reins at the Pentagon on Monday, becoming the third acting defense secretary since January.
Spencer is expected to temporarily lead the Pentagon while the Senate considers Army Secretary Mark Esper's nomination to succeed James Mattis as defense secretary. The Senate officially received Esper's nomination on Monday.
U.S. Special Operations Command may be on the verge of making the dream of flying infantry soldiers a reality, but the French may very well beat them to it.
On Sunday, French President Emmanuel Macron shared an unusual video showing a man on a flying platform — widely characterized as a "hoverboard" — maneuvering through the skies above the Bastille Day celebrations in Paris armed with what appears to be a dummy firearm.
The video was accompanied with a simple message of "Fier de notre armée, moderne et innovante," which translates to "proud of our army, modern and innovative," suggesting that the French Armed Forces may be eyeing the unusual vehicle for potential military applications.
A lawmaker wants to know if the Pentagon ever exposed the American public to ticks infected with bioweapons
If you've ever wondered if the Pentagon has ever exposed the American public to ticks infected with biological weapons, you're not alone.
Rep. Christopher Smith (R-N.J.) authored an amendment to the House version of the Fiscal 2020 National Defense Authorization Act would require the Defense Department Inspector General's Office to find out if the U.S. military experimented with using ticks and other insects as biological weapons between 1950 and 1975.
If such experiments took place, the amendment would require the inspector general's office to tell lawmakers if any of the ticks or other bugs "were released outside of any laboratory by accident or experiment design."