Traumatic brain injury (TBI) has been discussed as one of 14 risk factors contributing to dementia risk in a new 2024 Lancet Commission, Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission.
The new commission is an update of a 2020 Lancet Commission on dementia, having included findings from systematic reviews and meta-analyses since the 2020 commission.
TBI is discussed as continuing to be a risk factor for dementia, with new evidence suggesting that protection from head injury through contact sports should be an individual and public health priority, for which ambitious policy changes should be made at national and international governmental levels.
The commission offers an overview of key research studies conducted on the topic of TBI in sports, concluding that TBI increases dementia risk, possibly leading to earlier onset of dementia by 2 – 3 years than in non-TBI populations. A number of plausible underlying neuropathologies are suggested. Protection from head injury in sports is recommended to be an individual and public health priority, for instance by introducing appropriate head protection equipment, limiting heading practice and high-impact collisions, preventing playing immediately after TBI and possible adaptations of rule changes to limit injury.
The commission reports on 2 newly recognised modifiable risk factors for dementia, namely vision loss and high cholesterol, in addition to the previously recognised 12 risk factors of less education, head injury/TBI, physical inactivity, smoking, excessive alcohol consumption, hypertension, obesity, diabetes, hearing loss, depression, infrequent social contact and air pollution.
Other potentially modifiable risk factors are also discussed, namely too little sleep, an unhealthy diet, infections and mental health condition. However, these were considered to lack a strong enough evidence base for inclusion in the aforementioned list of risk factors.
The full 2024 Lancet Commission on dementia is available at www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)01296-0/fulltext.
Reference: Livingston, G., Huntley, J., Liu, K.Y., Costafreda, S.G., Selbæk, G., Alladi, S., et al. (2024). Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission. The Lancet Commissions, published 31 July 2024. DOI: https://doi.org/10.1016/S0140-6736(24)01296-0 .
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