Head injuries linked to dementia later in life

I've always believed that contact sports carried with them serious health consequences down the line. The most obvious are chronic musculoskeletal disorders such as arthritis and dysfunctional joints. But contact sports also involve head injuries. While the short term effects of head injuries has received a lot of press lately, with several papers updating the treatment of head injuries, and the guidelines for returning to the sport, little has been written about the long term effects.


Recently (Monday, July 18th, 2011) two studies were presented at the Alzheimer's Association international conference in Paris that head injuries in veterans and NFL players result in an increase in cognitive problems and dementia as they age.


One study looked at the medical records of about 300,000 veterans age 55 or older and found that 2% had suffered at least one traumatic brain injury resulting in a doubling of their chances of developing dementia. The second study looked at 4,000 retired NFL players and found that 35% of them had signs of significant cognitive problems. 


Previous studies have also shown that sports such as boxing and football


The bottom line is that more rules and better equipment should be put in place in any contact sport where head injuries are a relatively common occurance, as they are in football, hockey, soccer, rugby and several others. Also athletes in sports where head injuries are the norm and part of the sport, such as boxing (see abstract below) and mixed martial arts, should be aware of the significant mental and psychological implications of their sports.




Dtsch Arztebl Int. 2010 Nov;107(47):835-9. Epub 2010 Nov 26.

Boxing-acute complications and late sequelae: from concussion to dementia.

Förstl H, Haass C, Hemmer B, Meyer B, Halle M.


Klinik und Poliklinik für Psychiatrie und Psychotherapie, Technische Universität München, Ismaningerstr. 22, 81675 München, Germany.



Boxing has received increased public attention and acceptance in recent years. However, this development has not been accompanied by a critical discussion of the early and late health complications.


We selectively review recent studies on the acute, subacute, and chronic neuropsychiatric consequences of boxing.


Cerebral concussions ("knock-outs") are the most relevant acute consequence of boxing. The number of reported cases of death in the ring seems to have mildly decreased. Subacute neuropsychological deficits appear to last longer than subjective symptoms. The associated molecular changes demonstrate neuronal and glial injury correlated with the number and severity of blows to the head (altered total tau, beta-amyloid, neurofilament light protein, glial fibrillary acidic protein, and neuron-specific enolase). The risk of a punch-drunk syndrome (boxer's dementia, dementia pugilistica) as a late effect of chronic traumatic brain injury is associated with the duration of a boxer's career and with his earlier stamina. There are similarities (e.g. increased risk with ApoE4-polymorphism, beta-amyloid pathology) and differences (more tau pathology in boxers) compared with Alzheimer's disease.


Protective gear has led to a remarkable reduction of risks in amateur boxing. Similar measures can also be used in professional boxing, but may decrease the thrill, which does appeal to many supporters.

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