Dementia Pugilistica Or «boxer Dementia»

Dementia pugilistica is a neurodegenerative disorder. It has received attention in recent years as researchers have discovered more about the ripple effects of practicing certain sports. The second name, “boxer dementia”, gives you a clue about its etiology. The Latin word pugil refers to boxing. The repeated blows to the head during a boxing career are often what cause this type of dementia.

Although it would be difficult to calculate exactly how many times a contact athlete is hit in the head during his career, it is not difficult to imagine that these repeated blows have consequences.

Multitrauma and recurrent concussions lead to cortical atrophy in the brain, causing dementia pugilistica.

General characteristics of dementia pugilistica

In 1928, pathologist and forensic scientist Harrison Martland was the first to clinically describe dementia pugilistica.

Today, researchers categorize it as a variant of chronic traumatic encephalopathy. In the beginning, however, there was no difference between the two. Researchers noticed the difference when they realized that they only detected symptoms of dementia pugilistica in certain groups.

A silent disease

The popularity of boxing at the beginning of the 20th century inspired many professionals and fans to get involved in the sport. In the beginning, the consequences went unnoticed. Over the years, however, the number of cases of people with symptoms began to increase.

The most common symptoms were apathy, psychotic traits, loss of coordination and marked global intellectual impairment. Researchers understood the link between these symptoms and repeated micro-injuries to the brain caused by concussions.

Development of dementia pugilistica

Cortical atrophy of the brain leads to a general reduction in brain size. It also slows down the metabolism. In general, cortical atrophy affects all brain structures that adversely affect overall functionality.

This disease is progressive and the symptoms can vary:

• Early stage. The patient experiences the first symptoms of cognitive impairment from multitrauma. Although there is no clear “start date” for the disease, it tends to be latent in the first years.
• Advanced stage. Experts believe that the advanced stage usually begins about 12 to 16 years after the patient participates in the sport. At this point, the symptoms are obvious, but they can not yet be categorized as dementia.
• Dementia. Symptoms are established and affect all aspects of the patient’s functionality. Loss of mental qualities such as memory and reasoning becomes apparent and significantly affects behavior.

Main symptoms

The symptoms of dementia pugilistica vary, which is why it is easy to mistake them for other neurodegenerative diseases. Nevertheless, dementia pugilistica patients tend to share a group of symptoms, which become clearer over time:

• General apathy. Lack of emotional expression or interest, highlighted by a weakened communication ability.
• Aggressiveness. Physical and verbal aggression; patients become impulsive and irritable.
• Depression. The progressive nature of the symptoms tends to lead to loss of motivation, isolation and despair.
• Memory. Patients have the most problems with their daily tasks. Changes in memory correlate with difficulty paying attention and focusing.
• Motor problems. At first, patients seem just a little clumsy or careless. Over time, however, they become sluggish, stiff and uncoordinated.

Primary risk factors for dementia pugilistica

The most important risk factor for developing this type of dementia is participating in contact sports. Despite its name, boxing is not the only sport that can cause it. Here are other sports that put athletes at risk:

• American Football.
• Kickboxing.
• Sports with a lot of contact.
• Motorized racing sports.

Other risk factors also include:

• Starting with a contact sport at a young age.
• Not to use the protective equipment that experts recommend for the sport.
• An athletic career over time.
• Not practicing prevention strategies.

Diagnosis

Dementia pugilistica does not involve a specific injury or a specific brain area. Therefore, it is difficult to diagnose.

A neurologist and a neuropsychologist usually evaluate the patient with  behavioral and motor symptoms. Doctors also use neuroscopy (such as CT scans) to determine the degree of brain damage.

Treatment

The primary treatment for dementia pugilistica involves avoiding the risk factors. If you practice any of the above sports, you should take all possible measures to protect yourself and be careful.

If a patient already has symptoms, there are two common approaches:

• Medication. Treatment with pharmaceutical drugs that address specific symptoms.
• Rehabilitation. The patient should start treatment as soon as possible to take advantage of the plasticity of the brain. Therapists usually focus on teaching the patient ways to compensate for the loss of motor skills. The goal is for them to continue to function as normally as possible.

Things to consider

Dementia pugilistica is a very clear example of what happens when you do not take care of your brain. The changes appear in the long term, but the causes occur early in life.

The lack of immediate consequences makes it difficult to be fully aware of the damage. However, any activity that corrodes the nervous system will take a serious toll on the body over time. Eating well is a very important preventative method for all types of dementia.

Finally, it is important to remember that some popular sports are not necessarily healthy. This is especially true if you do not take the right precautions. A large percentage of former American football players have traumatic brain injuries. Their athletic careers will negatively affect them for the rest of their lives.

Finally, thanks to new studies and increased awareness of the risks, the sports community is taking measures such as compensating former players and investing more money in research.