Older veterans with traumatic brain injury (TBI) are 60% more likely to develop dementia later in life, compared with veterans without TBI, according to a study published online ahead of print June 25 in Neurology. The study involved 188,764 veterans ages 55 and older. At the study’s outset, each participant was free of dementia and had at least one inpatient or outpatient visit to a health care facility at baseline (2000 to 2003) and during the follow-up (2003 to 2012). A total of 1,229 veterans had a TBI diagnosis; 196 veterans with TBI (16%) developed dementia, and 18,255 (10%) of those without TBI developed dementia. On average, veterans with TBI developed dementia two years earlier than those without TBI. “If we assume that this relationship is causal, it seems likely that the same increased risk probably occurs with TBI in the civilian population as well,” said the researchers.
Higher levels of depressive symptoms, stress, and hostility are associated with a significantly increased risk of stroke or transient ischemic attack (TIA) in middle-aged and older adults, according to a study published online ahead of print July 10 in Stroke. Researchers used data from the Multi-Ethnic Study of Atherosclerosis (MESA) to determine how psychologic factors might influence the risk for chronic disease. The investigators examined data for 6,749 adults (ages 45 to 84; 53% women) as they completed questionnaires assessing chronic stress, depressive symptoms, anger, and hostility during a two-year period. Hazard ratios indicated a significantly elevated risk of stroke or TIA for the highest scoring group, compared with the lowest scoring group, for depressive symptoms (HR, 1.86), chronic stress (HR, 1.59), and hostility (HR, 2.22). No significant increased risk was associated with anger.
Patients with mild to moderate Parkinson’s disease can improve their symptoms with regular walking, according to a study published online ahead of print July 2 in Neurology. Investigators included 60 individuals who participated in a randomized trial of various exercise regimens for six months. Eighty-one percent of participants completed the study with a mean attendance of 83.3%. Subjects took additional tests to gauge their aerobic fitness, tiredness, and other factors. Brisk walking reduced tiredness by 11%, improved motor function and mood by 15%, improved attention and response control scores by 14%, and increased aerobic fitness and gait speed by 7%. With regard to motor function, participants improved by an average of 2.8 points. “The results of our study suggest that walking may provide a safe and easily accessible way of improving the symptoms of Parkinson’s disease and improve quality of life,” stated the researchers.
Mild traumatic brain injury (TBI) may result in brain damage and memory and thinking problems, according to a study published online ahead of print July 16 in Neurology. Fifty-three patients (44 with mild TBI and nine with moderate TBI) were compared with 33 participants without brain injury. Each subject underwent testing to assess his or her memory and thinking skills. Participants also had diffusion tensor imaging scans. Those with injuries had brain damage in white matter that consisted of disruption to nerve axons. Researchers also determined that scores on the verbal letter fluency task were 25% lower in individuals with injury than in individuals without injury. “We studied patients who had suffered clinically mild injuries, often from common accidents such as falling from a bicycle, or slow-speed car accidents. This finding is especially important, as 90% of all TBIs are mild to moderate,” said the researchers.
Patients with a traumatic brain injury (TBI) who received erythropoietin (EPO) or maintained a higher hemoglobin concentration through blood transfusion did not have an improved neurologic outcome at six months, according to a study published in the July 2 issue of JAMA. The randomized study included 200 patients (erythropoietin, n = 102; placebo, n = 98) with a closed head injury at neurosurgical intensive care units in two US level I trauma centers between May 2006 and August 2012. Patients were enrolled within six hours of injury and had to be unable to follow commands after initial stabilization. Overall, transfusing at higher hemoglobin concentrations was associated with a higher risk of adverse events. Researchers also observed a higher incidence of thromboembolic events for the transfusion threshold of 10 g/dL (21.8%) versus the threshold of 7 g/dL (8.1%)
Frontline Medical Communications and the National Organization for Rare Disorders (NORD) have signed a partnership agreement to develop educational programs about rare diseases for health care providers. Frontline and NORD also seek to improve awareness, recognition, and understanding of rare diseases among health care providers to accelerate diagnosis and promote optimal care for patients, facilitate the sharing of information among health care providers and rare disease medical experts, and update health care providers on new treatment options and clinical care standards. “Innovative multichannel educational programs, developed by both organizations and funded by commercial sponsors, will be distributed to more than 1.2 million health care providers using Frontline’s portfolio of 30 journal brands, corresponding websites, eNewsletters, and live events,” according to Frontline.