Summary: Researchers have found that cranial lesions, or “brain breaks”, increase the risk of developing memory later in life. Although blood clotting have long been associated with cognitive decline, ischemic strokes and memory are now more prevalent, according to this investigation.
Using Medicare information from nearly 15, 000 patients, researchers observed a two-fold increase in memory treatment within approximately 5.6 years after a brain burn. The findings point to the possibility that hemorrhages could possibly result from shared risk factors like serious vascular damage or amyloid beta buildup that could cause dementia.
Researchers emphasize the value of normal cognitive screening for hemorrhage patients in light of these findings. Future studies may look at the underlying mechanisms and assess the safety of Alzheimer’s medications in these individuals.
Major Information
- Increased Dementia Risk: The risk of dementia is doubled when there are cerebral lesions.
- Possible Factors: Hemorrhages may increase the risk of dementia by accumulating amyloid beta or by combining risk factors with degenerative diseases.
- Clinical Implications: People with brain breaks should be monitored for cognitive decline, and Alzheimer’s remedies may require readjustment in this class.
Origin: Weill Cornell University
Weill Cornell Medicine researchers have found that cranial lesions, or “brain breaks” caused by a ruptured blood vessel in the brain, twice a person’s risk of developing memory later in life.
While the relationship between memory and ischemic stroke caused by clotting that prevent blood supply to the brain has received more attention, the , new investigation, published Jan. 30 in , Stroke, extends previous studies to lesions.  ,
” We consistently see an increased risk of memory, regardless of the type of burn”, said initial author , Dr. Samuel Bruce, associate professor of neuroscience at Weill Cornell Medicine and a physician at NewYork-Presbyterian/Weill Cornell Medical Center.
This suggests that people who have had intracranial hemorrhage should be regularly tested for cognitive impairment because the results could influence the decisions made by the patients and their families regarding future care.
Using Medicare insurance claims from 2008 to 2018, Dr. Bruce and his colleagues assessed almost 15, 000 people who had various types of intracranial hemorrhages, which , cause , blood to collect in brain tissue or underneath the skull. Hemorrhages , can occur after head injuries,  , but the researchers focused on those that happened spontaneously.
In comparison to more than two million people who did not experience a hemorrhage, they observed a two-fold increase in the number of first-ever dementia diagnoses within an average of five years after an intracranial hemorrhage for these patients.
The findings add to earlier research that demonstrated the link between hemorrhages and later cognitive issues.
In , a study  , based on medical records in Denmark, for example, 11.5 % of people developed dementia after blood vessels ruptured within their brains, about a 2.5-fold increase over the general population. On the other hand, ischemic strokes, typically caused by blood clots, increased the risk of dementia by about 1.7-fold.
Why does a person’s risk of dementia rise as a result of an intracranial hemorrhage? There are a few possible reasons”, said senior author , Dr. Santosh Murthy, associate professor of neuroscience at the , Feil Family Brain &, Mind Research Institute , and of neurology at Weill Cornell Medicine.
Hemorrhages may directly lead to dementia by causing the brain’s and blood vessels to accumulate a protein called amyloid beta, which can cause impaired brain function. Or because the same things, such as chronic brain damage to blood vessels, increase the risk of both conditions, such as hemorrhage and dementia may be indirectly related.
” As we see more evidence that dementia can follow hemorrhages, we really need to consider the implications”, said Dr. Murthy, who is also a neurologist at NewYork-Presbyterian/Weill Cornell Medical Center.
” For example, assessing the safety of anti-amyloid beta treatments for Alzheimer’s disease in people who have experienced a hemorrhage should become a research priority”.
Further studies will need to be conducted to understand how hemorrhages contribute to various subtypes of dementia as new treatments for intracranial hemorrhages may ultimately lead to patients living longer after an incident.
About this news from neurology research
Author: Barbara Prempeh
Source: Weill Cornell University
Contact: Barbara Prempeh – Weill Cornell University
Image: The image is credited to Neuroscience News
Original Research: Closed access.
” Non-Traumatic Intracranial Hemorrhage and Risk of Incident Dementia in U. S. Medicare Beneficiaries” by Samuel Bruce et al. Stroke
Abstract
Non-Traumatic Intracranial Hemorrhage and Risk of Incident Dementia in U. S. Medicare Beneficiaries
Background:
To examine the possibility of incident dementia following a non-traumatic intracranial hemorrhage in a diverse US population and to determine whether this risk is different for each type of intracranial hemorrhage.
Methods:
We conducted a retrospective cohort study using Medicare beneficiaries ‘ inpatient and outpatient claims data from the years January 1, 2008 through December 31, 2018.
A composite of intracerebral hemorrhage ( ICH), subarachnoid hemorrhage ( SAH), and subdural hemorrhage ( SDH) was identified as a new form of non-traumatic intracranial hemorrhage ( SDH). The outcome was a first-ever diagnosis of dementia. The exposure and outcomes were identified using validated ICD-9 and ICD-10-CM diagnosis codes.
In order to ensure that only incident cases were included in our analyses, we excluded patients who had frequently experienced intracranial hemorrhage or dementia. In the primary analysis, we used Cox regression to study the risk of dementia after intracranial hemorrhage, after adjusting for demographics and comorbidities.
In secondary analyses, the risks of dementia were examined for various intracranial hemorrhage subtypes.
Results:
Among 2.1 million patients, 14, 775 had a diagnosis of intracranial hemorrhage. During a median follow up of 5.6 years ( IQR, 3.0-9.1 ), incident dementia was diagnosed in 2527 ( 17.1 % ) patients with an intracranial hemorrhage and 260, 691 ( 12.8 % ) in those without intracranial hemorrhage.
The cumulative incidence rate of dementia was 8.6 % ( IQR, 8.1-8.9 ) among patients with an intracranial hemorrhage, and 2.2 % ( 2.0-2.4 ) in patients without intracranial hemorrhage.
In adjusted Cox regression analysis, intracranial hemorrhage was associated with an increased risk of incident dementia ( HR, 2.0, CI, 1.9-2.2 ). In secondary analyses, a higher risk of incident dementia was observed with ICH ( HR, 2.4, CI, 2.2-2.5 ), SAH ( HR, 1.99, CI, 1.7-2.2 ), and SDH ( HR, 1.6, CI, 1.4-1.7 ).
Conclusion:
Intracranial hemorrhage was independently linked to a 2-fold higher risk of incident dementia in a large, heterogeneous cohort of elderly US participants. This higher risk was consistently observed for all different types of intracranial hemorrhage.
