Neurological
Intracerebral bleeding associated with an increased risk of cognitive decline at a young age
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Patients with intracerebral haemorrhage (ICH), especially after brain trauma, have an increased risk of cognitive decline at a relatively young age. This is evident from study results presented at the American Academy of Neurology (AAN) Annual Virtual Meeting 2021, April 17-17, 22, 2021.
The study’s researchers wanted to further investigate why survivors of ICH are at increased risk of cognitive decline by comparing the risk of dementia in young patients with traumatic and spontaneous ICH.
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From 2000 to 2018 they carried out a retrospective cohort study with 8733 patients with ICH between the ages of 20 and 60 years. They followed up for 10 years and used International Classification of Diseases (ICD) codes to determine traumatic and spontaneous ICH, as well as other phenotypes.
Study researchers excluded patients with pre-existing dementia or diagnosis made in the 6 months after ICH. They assessed the risk of dementia and the predictors using Cox proportional hazards and logistic regression models
2995 (34%) patients with ICH had traumatic ICH and 5738 (66%) had spontaneous ICH. Patients with traumatic ICH were younger (median 46 years; interquartile range [IQR]), 34-54; P <0.001) than patients with spontaneous ICH (median 49 years; IQR 41-55).
The 10-year cumulative incidence of dementia after spontaneous ICH was 1.3%, while that after traumatic ICH was 2.1% (P = 0.002). The results showed no significant difference between the time interval before dementia in two groups (P = 0.47). The risk of dementia after a traumatic ICH was higher than the spontaneous ICH (hazard ratio) [HR]1.5; 95% CI, 1.1-2.2; P = 0.02).
Study results suggest that the predictors of included thyroid disease (HR 2.7; 95% CI 1.2-5.5), depression (HR 1.6; 95% CI 1.1-2.4) and alcohol abuse (HR 1.8; 95% CI) are 1.1-2.7).
The study’s authors concluded that these results “highlight the long-term complications of acute brain injury [and] the importance of preventive measures and risk reduction strategies. “
References
Radmanesh F., Tahir Z., Yahya T. et al. Traumatic intracerebral bleeding carries a higher risk of dementia than spontaneous intracerebral bleeding. Presented at: American Academy of Neurology’s Annual Virtual Meeting 2021; 17.-22. April 2021. Abstract P16.004
