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Research paper
Population based study on patients with traumatic brain injury suggests increased risk of dementia
  1. Hao-Kuang Wang1,2,
  2. Sheng-Hsiang Lin1,
  3. Pi-Shan Sung1,3,
  4. Ming-Hsiu Wu1,4,
  5. Kuo-Wei Hung1,5,
  6. Liang-Chao Wang1,6,
  7. Chih-Yuan Huang1,6,
  8. Kang Lu2,
  9. Han-Jung Chen2,
  10. Kuen-Jer Tsai1
  1. 1Institute of Clinical Medicine, National Cheng Kung University, Tainan, Taiwan
  2. 2Department of Neurosurgery, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
  3. 3Department of Neurology, National Cheng Kung University Hospital, Tainan, Taiwan
  4. 4Department of Neurology, Chi Mei Medical Centre, Liouying, Tainan, Taiwan
  5. 5Department of Neurology, Yuan's General Hospital, Kaohsiung, Taiwan
  6. 6Neurosurgical Service, Department of Surgery, National Cheng Kung University Hospital, Tainan, Taiwan
  1. Correspondence to Professor K-J Tsai, Institute of Clinical Medicine, National Cheng Kung University, Tainan 704, Taiwan; kjtsai{at}


Objective The relationship between traumatic brain injury (TBI) and the risk of dementia remains controversial. This population based study was designed to estimate and compare the risk of dementia in TBI and non-TBI individuals during the 5 year period after TBI.

Methods This study was a retrospective cohort study. Data were obtained from the Longitudinal Health Insurance Database 2000. We included 44 925 patients receiving ambulatory or hospital care and 224 625 non-TBI patients; patients were matched for sex, age and year of index use of healthcare. Patients <15 years of age and those admitted to the intensive care unit were excluded. Each individual was studied for 5 years to identify the subsequent development of dementia. Data were analysed by Cox proportional hazard regression.

Results During the 5 year follow-up period, 1196 TBI (2.66%) and 224 625 non-TBI patients (1.53%) patients developed dementia. During the 5 year follow-up period, TBI was independently associated with a 1.68 (range 1.57–1.80) times greater risk of dementia after adjusting for sociodemographic characteristics and selected comorbidities.

Conclusions The findings of this study suggest an increased risk of dementia among individuals with TBI. We suggest the need for more intensive medical monitoring and health education in individuals with TBI.

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  • Competing interests None.

  • Ethics approval Ethics approval was provided by the National Health Research Institutes.

  • Provenance and peer review Not commissioned; externally peer reviewed.