My father has dementia. The handsome young man who went before I was born, the pleasant, elusive guy I have only met a few times in my life, is now struggling to remember names and understand the context. I got the news via a long-lost cousin recently, just a few days after my mother died after her own long and painful journey through Alzheimer’s. But my father’s neurological path has been very different from my mother’s, and it provides other warnings and lessons. It seems he has not inherited his condition. Nor did he develop it as an inevitable consequence of extreme old age, for he is not so old. Instead, it turns out that the seed for his disease was planted a long time ago.
My mother’s lineage was part of a frightening family legacy. Her sister started showing signs of early-onset Alzheimer’s when she was in her 50s, just like her older brother. My mother-in-law’s dementia, meanwhile, seems to be a result of her advanced age and the isolation of a pandemic that gave her COVID – twice. That was, I had assumed, how dementia happens to most people, via genetics and time. I did not realize how big the other risks are, even for those of us who are not boxers or football players. My father’s dementia is due to a head injury.
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I was aware of chronic traumatic encephalopathy (CTE). In recent years, it has been the subject of intense scrutiny and calls for serious reform across a range of sports. There was the case of Aaron Hernandez, the former New England Patriots tight-end and convicted murderer who died by suicide at the age of 27 in 2017. After his autopsy, researchers declared he suffered “the most serious case of chronic traumatic encephalopathy ever. detected in a person of his age, injury that would have had a material effect on his decision-making, judgment and cognition. ” That same year, a study conducted by neuropathologist Dr. Ann McKeen signs CTE in 99% of the brains of the deceased former National Football League players who were examined. Recently, there was former NFL player Phillip Adams, who in April last year shot and killed six people before turning the gun on himself. A posthumous brain examination “showed significantly dense lesions in both frontal lobes, an abnormally severe diagnosis for a person in their thirties.”
My father was not a professional athlete. As far as I know, he never played any team sport at all. When my cousin contacted me last month, she explained that his neurologist’s diagnosis was that the dementia was the result of a series of head injuries throughout his life, including a car accident he survived in his twenties. I had mistakenly assumed that prolonged injury from blows to the head was always the result of sustained and repeated punishments. I had read so much about athletic young men in their prime, dying with neurodegenerative conditions that made their brains seem much, much older and sicker. It had not dawned on me that someone with a skull, regardless of age, could also be vulnerable.
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As the Alzheimer’s Association explains, “certain types of traumatic brain injury can increase the risk of developing Alzheimer’s or another type of dementia years after the injury occurred.” In other words, while “There’s no evidence that a single mild traumatic brain injury increases the risk of dementia,” you also do not have to be out on the field every Monday night for years. You do not have to have been in a life-threatening accident. A 2018 study of military veterans found that “Even mild TBI [traumatic brain injury] without loss of consciousness was associated with more than a 2-fold increase in the risk of being diagnosed with dementia. “
Reframing the risks of dementia can be especially important for women who are twice as likely as men to be diagnosed with the condition. This matters because even though we as a whole may spend less time in boxing, we are far more likely to experience violence in intimate partnership. Back in 2018, senior researcher Dr. Don Weaver of the Toronto Western Research Institute researched the link between home abuse and dementia in the Canadian National Post and wrote: “A case-control study I conducted with colleagues shows that spousal abuse may be linked to the development of Alzheimer’s. “
As the awareness of the devastating neurological consequences of head injuries, regardless of age, increases, there is an opportunity to mislead our efforts. As NPR reported in December, a quiet population of ordinary men and women who have never played professional sports fear having the disease [CTE]. They panic after a cure and often turn to questionable treatments, controversial doctors or health care providers with financial interests in the products they recommend … from cannabis to neurological chiropractors. “Not surprisingly, they note,” the loosely regulated brain health industry benefits. “
Although there are promising treatments and clinical trials to curb the effects of dementia, there is no cure. Understanding the potential long-term consequences of head injuries and doing our best to avoid them remains our best option for a healthy brain. We can not prevent every fall or every crash, but we can use our seat belts and our bicycle helmets and talk to our doctors about events in our past that may affect our cognitive future. My neurologist and I have had lots of discussions about my gloomy family history, but now I can see how it would not hurt to take up the old ski accident.
I doubt my father ever had the slightest idea that a car wreck he lived through decades ago would come back and haunt him now. I wonder if he had what could have been done in the past to relieve his symptoms? My cousin sent me a picture yesterday of him at his wife’s recent funeral. He looks elegant in his black suit. And more than that, he looks so sad, and so very lost.
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