Dementia Resulting From Traumatic Brain Injury: What Is the Pathology?
Open accessAbstract
Traumatic brain injury (TBI) is among the earliest illnesses described in human history and remains a major source of morbidity and mortality in the modern era. It is estimated that 2% of the US population lives with long-term disabilities due to a prior TBI, and incidence and prevalence rates are even higher in developing countries. One of the most feared long-term consequences of TBIs is dementia, as multiple epidemiologic studies show that experiencing a TBI in early or midlife is associated with an increased risk of dementia in late life. The best data indicate that moderate and severe TBIs increase risk of dementia between 2- and 4-fold. It is less clear whether mild TBIs such as brief concussions result in increased dementia risk, in part because mild head injuries are often not well documented and retrospective studies have recall bias. However, it has been observed for many years that multiple mild TBIs as experienced by professional boxers are associated with a high risk of chronic traumatic encephalopathy (CTE), a type of dementia with distinctive clinical and pathologic features. The recent recognition that CTE is common in retired professional football and hockey players has rekindled interest in this condition, as has the recognition that military personnel also experience high rates of mild TBIs and may have a similar syndrome. It is presently unknown whether dementia in TBI survivors is pathophysiologically similar to Alzheimer disease, CTE, or some other entity. Such information is critical for developing preventive and treatment strategies for a common cause of acquired dementia. Herein, we will review the epidemiologic data linking TBI and dementia, existing clinical and pathologic data, and will identify areas where future research is needed.
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Moderate and severe TBIs increase risk of dementia between 2- and 4-fold compared with risk among individuals without a history of moderate or severe TBI.
“Moderate and severe TBIs increase risk of dementia between 2‐ and 4‐fold compared with risk among individuals without a history of moderate or severe TBI.”
From 2024 Alzheimer's disease facts and figures (2024) · cites this paper as [199]
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- Authors
- Shively, S., Scher, A. I., Perl, D. P., & Diaz-Arrastia, R.
- Affiliations
- Uniformed Services University of the Health Sciences (US)
- Henry M. Jackson Foundation (US)
- Corresponding author
- Diaz-Arrastia, Ramon
- Venue
- Archives of Neurology
- Publisher
- American Medical Association (AMA)
- Published
- 2012-10-01
- Volume
- 69
- Issue
- 10
- Pages
- 1245-51
- ISSN
- 0003-9942 (ISSN-L)
- PMC
- PMC3716376
- OpenAlex
- W2135488666
- Cited by
- 346
- References
- 44
- Citations by year
- 2026: 14 · 2025: 28 · 2024: 35 · 2023: 26 · 2022: 36 · 2021: 11 · 2020: 28 · 2019: 29 · 2018: 22 · 2017: 21 · 2016: 26 · 2015: 17 · 2014: 28 · 2013: 23 · 2012: 2
- FWCI
- 16.76
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Archives of Neurology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (Z99 NS999999)
- U.S. Public Health Service (H133 A020526)
- National Institute on Aging (P50 AG 05138, P01 AG 02219, P30AG012300, P50AG005138, P30AG-12300, P01AG002219)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD048179)
- Topics
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Health Sciences › Medicine › Neurology › Traumatic Brain Injury and Neurovascular Disturbances
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Keywords
- traumatic brain injury, dementia, chronic traumatic encephalopathy, mild traumatic brain injury, concussion, professional boxers, professional football players, military personnel, dementia risk, Alzheimer's disease, dementia epidemiology
- MeSH terms
- Brain Injuries, Combat Disorders, Dementia, Humans, Risk Factors, Neurodegenerative Diseases
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