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I was pleased to be a featured speaker at the International Conference on Mild Traumatic Brain Injury held last week in Vancouver, Canada.  The MTBI 2009 assembled experts from a multiplicity of specialties working with brain injury, welcomed a diverse group of experts to collaborate in synthesizing new knowledge.  The conference brought together delegates from around the world, working in areas ranging from the medical and legal implications of MTBI to those working mental health/addiction issues as well as representatives from programs that provide acute, chronic rehabilitation and recovery services.

I spoke on the topic of mild traumatic brain injury and the courtroom.  Also speaking on the program were such internationally renowned experts as Gregory O’Shanick, medical director of BIAA who spoke on the topic “What is so mild about MTBI?”  Also speaking was Erin Bigler, Ph.D., who spoke on neuroimaging and persistent post concussion syndrome; Thomas Kay, Ph.D., who spoke on using the neuropsychological evaluation to understand the person with mild traumatic brain injury; as well as Grant Iverson, Ph.D., who spoke on clinical and methodological challenges associated with identifying residual cognitive deficits.

The conference was organized by Raymond Ancill, M.A. and Stephen Holliday, Ph.D. both of Vancouver, Canada. 

I read an interesting article on The New York Time’s website last week which discusses a rarely seen but yet devastating side effect of brain injuries: patients who  become profoundly suspicious of their closest relationships, often cutting themselves off from those who love them and care for them. They may insist that their spouse is an impostor; that their grown children are body doubles; that a caregiver, a close friend, even their entire family is fake, a duplicate version. Doctors believe these delusions are symptoms of schizophrenia, however recently, researchers have found similar delusions in hundreds of people who are not schizophrenic but have neurological problems including dementia, brain surgery and traumatic blows to the head.

Now a small group of scientists are researching what makes a person’s identity in their brain. Learning what makes identity, researchers say, will help doctors understand how some people preserve their identities in the face of creeping dementia, and how others are sometimes able to reconstitute one.

You can read the full article online here.

The North American Brain Injury Society is pleased to announce that the 22nd Conference on Legal Issues in Brain Injury will be held October 14-17, 2009, at the Austin Downtown Hilton Hotel. The program for the Conference is now available on the NABIS website and includes information on the topics to be discussed, a list of presenters scheduled to attend, and information on continuing legal education credits.

You can access all of the Conference's information online here.

NEW YORK (Reuters Health) - Older people poorly understand most of the important warning signs of stroke and factors that increase risk for this medical emergency, researchers from Dublin, Ireland, have found.

Among 2033 older men and women, fewer than half knew that dizziness, numbness, weakness, and headache are common warning signs of stroke, report Dr. Anne Hickey, of Royal College of Surgeons in Ireland and colleagues.

Just 54 percent listed slurred speech as an indicator of stroke, the researchers report in the online journal BMC Geriatrics.

When asked to list the most common risk factors for stroke, about three-quarters of the men and women accurately listed high blood pressure. By contrast, 40 percent or fewer knew high cholesterol and smoking also increase stroke risk. Only about 10 percent knew diabetes and alcohol use are also risk factors for stroke.

These findings highlight the significant gaps in elders' understanding of early stroke warning signs and risk factors, Hickey and colleagues report. "As such, many older adults may not recognize early symptoms of stroke in themselves or others," they warn. Thus, they may lose "vital time" in getting help.

On average, the study sample was 74 years old and 57 percent female. Overall, 25 percent of the men and women had a history of heart disease and 6 percent reported a prior stroke.

Another 36 and 17 percent were past and current smokers, respectively, and this group was more likely to identify smoking as a stroke risk factor than never smokers.

However, consistent with the findings of other investigators, this study revealed the generally poor understanding elders have regarding factors leading to or indicative of stroke, Hickey and colleagues note.

Since effective stroke care requires rapid identification and medical intervention, Hickey's group suggests the need for substantially improved public education with regard to stroke prevention.

SOURCE: BMC Geriatrics, August 2009

Copyright © 2009 Reuters Limited.

NEW YORK (Reuters Health) - Binge drinking is usually seen as a problem of college campuses, but many older adults may be overindulging in alcohol as well, a study published Monday suggests.

Using data from a government survey of nearly 11,000 Americans age 50 and up, researchers found that 23 percent of men between the ages of 50 and 64 admitted to binge drinking in the past month, as did roughly 9 percent of women.

Among adults age 65 and older, more than 14 percent of men and 3 percent of women reported bingeing -- defined as having five or more drinks on one occasion, on at least one day in the past month.

Alcohol binges are often considered a problem of youth. One recent government study found that among U.S. college students between the ages of 18 and 24, 45 percent reported a recent drinking binge.

But the new findings, published in the American Journal of Psychiatry, show that older adults can be susceptible too.

"We feel that our findings are important to the public health of middle-aged and elderly persons as they point to a potentially unrecognized problem that often 'flies beneath' the typical screen for alcohol problems in psychiatry practices," lead researcher Dr. Dan G.

Blazer, of Duke University Medical Center in Durham, North Carolina, noted in a written statement.

Blazer and colleague Dr. Li-Tzy Wu based their findings on a national health survey conducted between 2005 and 2006. Along with binge drinking, the survey looked at so-called at-risk drinking -- drinking habits that could have negative effects on a person's health. In this study, that was defined as averaging at least two drinks per day.

Among 50- to 64-year-olds, 19 percent of men and 13 percent of women were at-risk drinkers. The figures among older men and women were 13 percent and 8 percent, respectively.

Binge drinking carries a number of risks, including accidental injuries, violent behavior, neurological damage and blood pressure increases. These hazards, Blazer and Wu write, "clearly present" greater consequences later in life, when people often have chronic health conditions that can be aggravated by heavy drinking.

Yet, the researchers note, most people who binge are not dependent on alcohol, so their problem drinking may go unrecognized.

The message for doctors, Blazer said, is that they should be asking their older patients specifically about binge drinking.

Patients who do report bingeing may also need to be screened for other types of substance abuse, according to the researchers.

In this study, men who reported binge drinking had a higher risk of illegal drug use than men who drank but did not binge, while female binge drinkers had a heightened likelihood of prescription drug abuse.

SOURCE: American Journal of Psychiatry, online August 17, 2009.

Copyright © 2009 Reuters Limited.