Veterans' brain injuries: Worse than the NFL?

A pair of new studies reveal that the long-term effects of concussions and brain injuries could put soldiers in the same high-risk category for dementia as professional football players. These studies are of particular concern to veterans of the Iraq and Afghanistan wars, since brain trauma is rapidly becoming the signature injury associated with those conflicts. Here, a brief guide:

What kinds of head injuries are involved?

A study of more than 280,000 veterans found that a relatively small fraction of ex-soldiers had injuries like concussions, skull fractures, and other types of head trauma. Compare that to another study on the effects of concussions on more than 500 football players, which found that the average college player receives more than 250 blows to the head exceeding 30G in force, enough to result in serious injury.

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What did the two studies reveal?

About 35 percent of retired NFL players have significant cognitive problems, like poor memory and language skills; rates that high are usually seen only in much older people. The study of veterans found that those who had suffered brain injuries were more than twice as likely to receive a later diagnosis of dementia, compared to vets who had never had a serious brain injury.

Why do brain injuries plague today's troops?

In earlier wars, bodily injuries were more common, but with advances in protective body armor, those types of wounds occur less frequently. Today's soldiers in Iraq and Afghanistan, who often encounter improvised explosive devices (IEDs) and rocket-propelled grenades (RPGs), are vulnerable to the shock waves produced when these devices explode. Even when no bodily injuries can be seen, these blasts often result in brain trauma.

How do these injuries lead to dementia?

Researchers aren't entirely sure, but there's a growing body of evidence suggesting that changes to the brain following a serious injury often look like the changes that accompany Alzheimer's disease and other forms of dementia. The brains of football players, boxers, and other athletes, for example, often have beta-amyloid plaques and neurofibrillary tangles, two hallmarks of Alzheimer's.

What's being done to prevent these brain injuries?

Heightened awareness among military officials and professional sports organizations has changed the way concussions and other head injuries are addressed. The NFL, for example, has implemented rules that require players with any signs of a concussion be kept off the field until they are examined by a neurologist. And the U.S. military now has specially trained medical personnel in the field to immediately treat and track soldiers with head trauma; formerly, they needed to be evacuated to receive treatment.

Are these measures enough to prevent long-term problems?

Maybe not — the Government Accountability Office has determined that the military's efforts to diagnose and treat brain trauma are so "dysfunctional" that the armed forces can't be trusted to solve this problem. And 75 former NFL players are suing the league, claiming the organization withheld information about the dangers of head trauma for 90 years. One researcher suggested that the public health impact of brain trauma could be enormous, since every year 1.7 million cases of the condition are reported in the U.S., and troops in Afghanistan and Iraq continue to suffer head injuries at very high rates.

Sources: ABC.net.au, ESPN, MedPage Today, (2), Military Times, MSNBC.com, NPR