Appearing on a major national news program, University of California, San Francisco (UCSF) researcher Kristine Yaffe, MD shared key scientific findings of the increased dementia risk for military veterans who sustained traumatic brain injury.
Dr. Yaffe, who both sees patients and conducts research through her roles as a UCSF professor and chief of Geriatric Psychiatry and director of the Memory Evaluation Clinic at the San Francisco Veterans Affairs Medical Center, has previously done work through a BrightFocus research grant and has served on the scientific review panel for the foundation’s Alzheimer’s program.
Dr. Yaffe joined MSNBC anchor Richard Lui on a segment to mark World Alzheimer’s Day. Lui has previously interviewed leading brain and eye researchers at the past two An Evening of BrightFocus events.
Lui highlighted a study Dr. Yaffe and colleagues published showing that U.S. military vets who suffered even a mild traumatic brain injury (TBI) have a 2-3 times increased risk of developing dementia compared to those who did not have a TBI (Barnes et al, JAMA Neurology, 2018). The risk increases with severity and loss of consciousness, and for individuals who experienced a moderate to severe TBI, the risk of dementia nearly quadrupled. The study included all patients diagnosed with a TBI in the VA Health Care System from 2001 to 2014, and an equal number of VA participants without TBI, totaling more than 350,000 patients.
About 15-20 percent of the 350,000 American men and women who served during the wars in Iraq and Afghanistan experienced at least one mild TBI, according to military sources, frequently from exposure to shock waves following an explosion.
“I’m looking at that three X, compared to others, and that has to be alarming to many folks. Why is that dynamic there,” Lui asked Dr. Yaffe on the program.
“We know that having a TBI increases one’s risk of developing dementia many years later. We don’t know exactly what’s going on. We really need to get to the bottom of this,” Dr. Yaffe said.
“One possibility is that by having a head injury, you are more vulnerable to natural aging forces,” she said. “Another possibility is that there’s something about the TBI that leads to abnormal proteins that cause damage to the neurons and lead to dementia. Those are the two main ideas.”
Dr. Yaffe has spent her career looking into modifiable early risk factors for Alzheimer's disease, and has conducted many studies involving veterans and their families. In addition to TBI, her research has focused on how factors such as lack of sleep and stress may contribute to dementia risk, as well as chronic illnesses starting at midlife, such as diabetes and heart disease, if not brought under control.
As a 2010-14 BrightFocus Alzheimer's Disease Research grantee she looked at the impact of diabetes and glucose regulation on cognition and brain aging. “We are in the midst of two important converging demographic shifts in this country,” she wrote at the time. “One is the "graying" of America and the exponential expansion of the elderly population and the other is the rapid growth of obesity and diabetes in this country, due to changes in our lifestyle.”
Dr. Yaffe has published more than 400 research papers on how modifiable risk factors contribute to Alzheimer’s and dementia.
“I believe that prevention is a key component of reducing the burden of AD for both individuals and society and I will continue to concentrate my efforts on addressing this critical public health issue,” she said in 2016 interview with BrightFocus.
When asked on MSNBC if there is any way to offset the increased risk of dementia from TBI, Dr. Yaffe shared a similar message. “One of the first things you want to try and do is prevent, so we really do need to increase public health awareness to avoid TBI, if possible,” as well as allow time for recovery, she said.
“The other thing is to try and explain to our children, and to everybody, that what you do when you’re young, and even in middle age, can add to your risk of dementia down the line,” she said, calling for “a public health campaign to try and understand how to take care of your brain and prevent a lot of different risk factors, including TBI.”
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