Traumatic brain injuries (TBIs) are a major cause of death and disability. In the United States, they are a contributing factor in about a third of all injury-related deaths and can have life-long effects on those with less severe injuries. New studies are bringing to light the prevalence and effects of these injuries.
A Blue Cross Blue Shield Report, released on September 27, found that concussion diagnoses have rapidly increased in the past five years. Concussion diagnoses increased 43 percent from 2010 through 2015 as a whole in the U.S. and spiked 71 percent for patients ages 10 through 19 in the same span. For the 10 to 19 year old age group, the fall is peak concussion season, likely reflecting football season. Concussion diagnoses for young males in the fall are nearly double that of young females. Additionally, the study found an 81 percent increase in post-concussion syndrome in concussion patients across all ages.
Greater awareness of concussions is the main reason for this increase in diagnoses. Along with greater media coverage, “shake-it-off” laws that require young athletes who possibly suffered a concussion to be medically cleared before returning to a game may have led to this spike in diagnoses. However, as the New York Times notes, “the sheer numbers also suggest that more young people, particularly young athletes, are experiencing head injuries than in the past.”
In one of the largest and most comprehensive studies of traumatic brain injuries to date, researchers found that children and adolescents who suffer a concussion are significantly more prone to a range of medical and social problems during adulthood. The study also concluded that the severity, timing, and recurrence of these brain injuries significantly influenced these problems.
The study, which was published in PLOS Medicine on August 23, 2016 used national registers of the entire Swedish population born between 1973 and 1982, covering 1.1 million people. Of the entire Swedish population, 9.1 percent in this range had sustained a TBI before age 25. In addition to comparing the population of individuals exposed to a TBI with the population as a whole, the study also examined affected vs unaffected siblings in order to reduce the influence of confounding variables like familial incomes and hereditary predisposition.
Even a single concussion during childhood or adolescence is linked to lingering effects during adulthood. The study found that:
“being exposed to a mild TBI was associated with a range of adverse outcomes, including disability pension, psychiatric visits and inpatient hospitalisation, premature mortality, low educational attainment, and welfare recipiency.”
Researchers determined that these effects are amplified by several risk factors. More severe brain injuries were strongly associated with more severe negative outcomes later in life. Suffering from multiple TBIs also amplified these medical and social problems. The age of first injury was also determined to be significant, as the brain is more resilient earlier in childhood. Higher age of first injury was correlated with more severe outcomes, particularly after the age of 15.
The study’s conclusions that TBIs have a dose-response relationship with these adverse outcomes are consistent with past research. The large sample size and comparison within families gives strong support to these conclusions. These findings underscore the importance of “shake-it-off” and other initiatives to increase diagnoses of traumatic brain injuries. Also, the correlation of adverse effects with injury severity, timing, and severity suggests a need for more extensive and systematic follow-ups of children diagnosed with TBI.
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