Intracerebral Hemorrhage Linked to Increased Risk of Cognitive Decline at Young Age

The following article is part of conference coverage from the American Academy of Neurology (AAN) 2021 Virtual Annual Meeting. Neurology Advisor’s staff will be reporting breaking news associated with research conducted by leading experts in neurology. Check back for the latest news from the AAN 2021 Virtual Annual Meeting.

Patients with intracerebral hemorrhage (ICH), especially following brain trauma, are at increased risk of cognitive decline at a relatively young age, according to study findings presented at the American Academy of Neurology (AAN) 2021 Virtual Annual Meeting, held from April 17 to 22, 2021.

Study researchers sought 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.

From 2000 to 2018, they conducted a retrospective cohort study of 8733 patients with ICH who were from 20 to 60 years of age. They conducted follow-ups 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 following ICH. They assessed dementia risk and predictors using cox proportional hazards and logistic regression models, respectively

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 <.001) than patients with spontaneous ICH (median, 49 years; IQR, 41-55).

The 10-year cumulative incidence of dementia following spontaneous ICH was 1.3%, while that after traumatic ICH was 2.1% (P =.002). Findings indicated no significant difference between time interval before dementia in two groups (P =.47). The risk of dementia following traumatic ICH was higher than spontaneous ICH (hazard ratio [HR], 1.5; 95% CI, 1.1-2.2; P =.02).

Study findings suggested that the predictors of included thyroid disorders (HR, 2.7; 95% CI, 1.2-5.5), depression (HR, 1.6; 95% CI, 1.1-2.4), and alcohol misuse (HR, 1.8; 95% CI, 1.1-2.7).

The study authors concluded that these findings “highlight the long-term complications of acute brain injuries [and] the importance of preventative measures and risk reduction strategies.”

References

Radmanesh F, Tahir Z, Yahya T, et al. Traumatic intracerebral hemorrhage confers a higher risk for dementia than spontaneous intracerebral hemorrhage. Presented at: the American Academy of Neurology 2021 Virtual Annual Meeting; April 17-22, 2021. Abstract P16.004