TBI — A New Term for the Dementia Handbook

Cause and effect are words that haunt us when caring for someone with dementia. Many times I ask myself how my health conscious mom ended up with such an awful disease. Is it genetic or did she suffer an early trauma that we don’t know about? Luckily I’m not the only person asking that question.

Between the Pond and the Woods

New research has been conducted to analyze huge volumes of medical records to see if there’s a connection between Traumatic Brain Injury (TBI) and later development of dementia. The research was carried out by Deborah E. Barnes, PhD, MPH, Allison Kaup, PhD, Katharine A. Kirby, MA, Amy L. Byers, PhD, MPH, Ramon Diaz-Arrastia, MD, PhD and Kristine Yaffe, MD of the University of California at San Francisco. The article describing their study appears in Neurology, the official journal of the American Academy of Neurology. Because they studied patient records and not brain chemistry, their work is easier to understand than many other scientific papers.

Basically, this research team reviewed medical records for 188,764 U.S. veterans who were 55 years of age or older. All patients in the study had at least one inpatient or outpatient visit during the period under review and none had a dementia diagnosis at their first visit.

By examining nearly a decade’s worth of patient records, the researchers tallied the number of veterans who had a diagnosis of Traumatic Brain Injury (TBI) to see if TBI was associated with an increased incidence of dementia.

The research findings provide lots of food for thought. After controlling for the impact of other health factors, TBI in older veterans was associated with a 60% increase in the risk of developing dementia over 9 years.  According to the study’s authors, “TBI in older veterans may predispose toward development of symptomatic dementia”.  The study also raises a host of questions about how to treat TBI in younger veterans and other members of our society who have suffered brain injuries.

For lots of us, these finding won’t resolve the “cause/effect” question. But they give us plenty to think about while living in a society where so many young athletes suffer sports concussions, adults want to ride motorcycles without a helmet, and thousands of young people go off to fight in wars. I’m not suggesting that we cease all of these activities, just that we consider the cost that may be paid by those now suffering preventable pain.

Caregiver Advice: GO OUTSIDE!

Today is Sunday and it’s a beautiful day. Don’t hate me if I’m inspired to preach. My sermon will be short: GO OUTSIDE! While you think of all the obstacles that could keep you from doing that, here are some good reasons why you must.

Between the Pond and the Woods

Butterfly garden at Nescopeck State Park

A nice stroll and the smell of grass will go a long way to helping you feel good if you don’t have time to do more. This can be accomplished even if you need to cajole someone else to go with you — or push a loved one’s wheelchair. The Alzheimer’s site recommends the following joint outdoor activities to promote caregiver health:

  • Take a walk together outside to enjoy the fresh air
  • Go to the mall and stroll there
  • Garden or do other routine activities that you both enjoy

Do you need more reasons to go out and move around?

  • Research like the Evercare study shows that caregivers’ health suffers due to their lack of time and energy to prepare proper meals or to exercise. In this national survey, 60% of caregivers said that their eating (63%) and exercise  (58%) habits were worse than before.
  • A study by Haley, et al, showed that caregivers are at risk for increased mortality, coronary heart disease and stroke, particularly under conditions of high strain.

I’m ending the list here since almost everyone knows the bad news already. Instead, let’s consider the good news. The Mayo Clinic says that just a regular brisk walk can help you:

  • Maintain a healthy weight
  • Prevent/manage heart disease, high blood pressure, type 2 diabetes
  • Strengthen your bones
  • Lift your mood
  • Improve your balance and coordination

If that isn’t enough to get you off the couch, consider these sage words from Ralph Waldo Emerson:

“In the woods, a man casts off his years…I feel that nothing can befall me in life — no disgrace, no calamity, which nature cannot repair. In the woods we return to reason and faith.” [from his essay on Nature]

I may be old fashioned, but I love reading Emerson’s tributes to nature and its power to transform the way we feel. Since I am a bit modern, too, I can also condense the forty pages of Emerson’s essay to one excellent idea: GO OUTSIDE!