By Thomas Lehrich, President, Traumatic Brain Injury Foundation, Plus One Foundation of Seattle
A groundbreaking study from researchers at Boston University’s Chronic Traumatic Encephalopathy (CTE) Center has provided the evidence that many of us in the brain-injury advocacy community have long suspected: severe CTE isn’t just associated with dementia, it can be a cause of it.
For numerous decades, families of individuals exposed to repetitive head trauma, from contact sports, military service, domestic violence, and other causes, have watched loved ones struggle with memory loss, confusion, and cognitive decline.
The scientific community has debated whether CTE causes these clinical symptoms or if it’s merely an incidental finding at autopsy.
The Boston University work, published in Alzheimer’s and Dementia: The Journal of the Alzheimer’s Association, is the largest and most definitive of its kind.
Researchers studied 614 donated brains from individuals exposed to repetitive impacts and found those with advanced CTE had four to four-and-a-half times greater odds of having dementia compared with those without CTE pathology.
Importantly, the study isolated CTE from other neurodegenerative conditions, showing that this connection is not merely a correlation but a strong, independent association with cognitive decline and dementia.
Why This Matters
For too long, patients had unclear messages about CTE’s relevance to symptoms. This study of over 600 brains shifts how we think about repetitive brain trauma and its long-term consequences.
CTE should be formally recognized as one of the causes of dementia. Just as Alzheimer’s disease and other neurodegenerative conditions are classified within the realm of “Alzheimer’s disease-related dementias,” so too should severe CTE. This recognition matters, not only for research and clinical diagnosis but for families struggling to understand why their loved one’s cognition deteriorated.
Think About It
At Plus One, we have long championed education as one of the most powerful tools for helping our stakeholders
Our signature initiative, Think About It, is designed to reach the neurological communities with evidence-based education about concussion, repetitive head impacts, and long-term brain health.
Studies have shown that repeated subconcussive and concussive impacts — even those that don’t cause immediate blackout symptoms — contribute over time to cumulative brain injury. CTE pathology is characterized by abnormal tau protein accumulation in specific brain regions, likely driven by repetitive trauma.
Now, with a clearer link to dementia, the message of Think About It is more urgent than ever: brain health matters across the lifespan. Early education, timely recognition, and a culture that prioritizes neurological safety can change outcomes for countless individuals.