Researchers from the University of British Columbia (UBC) have been awarded $3.4 million to lead a community-based project aimed at improving the diagnosis of brain injury in survivors of intimate partner violence (IPV) and exploring possible connections to Alzheimer’s disease and related dementias.
While research indicates up to 92 per cent of survivors of IPV experience concussion or strangulation that can cause brain injury, evidence-based methods of diagnosing these injuries in this vulnerable population are lacking. This leaves many survivors, predominantly women, without access to medical care and other support services that are routinely offered to others who sustain a brain injury from other causes.
Brain injury can cause a range of devastating short, long-term, and chronic physical, psychological, and emotional effects, particularly in women already struggling to survive within, or after leaving, an abusive relationship.
“Intimate partner violence is a public health crisis, affecting one third of women globally and 44 per cent of women in Canada,” says project lead Dr. Cheryl Wellington, professor of pathology and laboratory medicine at UBC and researcher at the Djavad Mowafaghian Centre for Brain Health (DMCBH). “With our research, we hope to increase awareness of the prevalence and severity of brain injury in survivors of IPV, and to improve diagnosis and care overall.”
The project is a collaborative effort between partners from UBC Vancouver, UBC Okanagan, Vancouver Island University, Fraser Health, and Supporting Survivors of Abuse and Brain Injury through Research (SOAR).
The research team aims to determine whether protein biomarkers in the blood can objectively correlate with brain injury in survivors of IPV. It’s believed these biomarkers will improve clinical diagnosis in acute and chronic cases, providing earlier access to treatment and support, and helping differentiate between the mechanism of injury. In particular, the team will consider brain injury from IPV as a potential risk factor for Alzheimer’s disease and related dementias and look for blood biomarkers that correlate with these conditions.
“We have collected preliminary blood biomarker data that showed proteins previously linked to brain injury were higher in survivors of IPV than they would be in the general population,” says Dr. Wellington. “These initial findings may help us detect brain injury in survivors of IPV who have experienced head impacts or strangulation.”
Community-based research
For the project, researchers will obtain and analyze blood samples from survivors at various B.C. healthcare facilities, including Embrace Clinic at Surrey Memorial Hospital in the Fraser Health region, Nanaimo Regional and Cowichan District Hospitals in the Island Health region, and community-based organizations in Kelowna.
“Our work to date indicates brain injury is happening in much higher numbers, and having more chronic effects in survivors than most researchers, health care practitioners, and other frontline workers realize,” notes co-investigator Dr. Paul van Donkelaar, professor in the School of Health and Exercise Sciences at UBC Okanagan and researcher at the DMCBH. “Identifying links between brain injury from IPV and Alzheimer’s disease and related dementias has huge implications for improving upstream recognition and response, and saving on longer-term health care and human costs.”
Using an integrated knowledge translation approach, which emphasizes community engagement and participatory research, the research team will collaborate closely with community partners and lived experience survivors to develop knowledge tools and clinical guidelines. These guidelines will provide trauma-informed guidance for researchers and practitioners, particularly those studying Alzheimer’s disease and related dementias, to help facilitate discussions about IPV and ensure comprehensive care for survivors.
The project is being funded by the United States Department of Defense as part of the United States Army Medical Research and Development Command and was selected based on its potential to improve health outcomes in IPV survivors, both in civilian and military populations, and ultimately help them achieve healthier lives.
Project partners joined in recognizing the important impact the investment will have.
“The incidence of intimate partner violence is particularly high in the central and north Vancouver Island regions. Our team is excited to contribute to this important and innovative research program in collaboration with the Island Health forensic nurse team and community partners such as Nanaimo Brain Injury Society,” said Dr. Sandy Shultz, professor at Vancouver Island University and director of the Vancouver Island Centre for Trauma & Mental Health Research.
“Given as many as 92 per cent of survivors of intimate partner violence may also experience brain injury, and women are twice as likely to develop Alzheimer’s disease than men, there is a clear need to ensure survivors receive the highest levels of care. We are looking forward to working with the project team to increase awareness and education in the field,” said Karon Mason, co-founder and executive director of SOAR.
“At Embrace Clinic, we offer specialized medical care for people who have experienced recent violence. Long-term, we know that survivors who have experienced strangulation and concussion are also at risk for chronic health conditions and permanent disability that often goes unrecognized. I am hopeful this research will lead to better diagnosis and treatment of brain injury in survivors of intimate partner violence and bring greater awareness about the implications and seriousness of these crimes,” said Hannah Varto, forensic nurse practitioner, Embrace Clinic, Fraser Health.