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Traumatic Brain Injury Can Unexpectedly Cause Disability Years Later


While some effects of brain damage may be evident immediately following a traumatic brain injury (TBI), serious disabilities due to cognitive impairment may not became apparent until much later in life. Because of this, it is difficult to predict accurately the extent of the long-term disabilities a person suffering from a TBI may experience. Cognitive disabilities, including mild cognitive impairment (MCI), caused by TBI are significant sources of morbidity. Research has linked TBI to a greater risk of developing Alzheimer’s and other types of dementia years after the actual injury. Current research has begun to show that a history of TBI not only increases the risk that an individual will develop MCI, but it also makes it more likely that they will experience MCI earlier in life than individuals without a history of TBI. With approximately 1.7 million Americans being treated for a TBI each year, according to the California Brain Injury Association, it is important that attorneys representing those individuals utilize experts, such as life care planners, to help determine a plaintiff’s expected future damages.

Traumatic brain injury is a leading cause of injury-related death and disability in the United States. A TBI is an injury to the head or brain that changes the brain’s normal functioning. TBIs are most commonly caused by accidental falls, bicycle accidents, car collisions, and physical assaults. Cognitive problems are typically evaluated immediately following the injury, and again once the patient’s condition has stabilized. While TBI can cause immediate and short term problems such as headache, confusion, dizziness, blurred vision, fatigue and memory loss, researchers have recently discovered that TBI is also a risk factor for the development of MCI, even years after the injury. The physical location of the TBI, its severity, and the age and general health of the individual are all factors relevant to the future disabilities which may arise from TBI.

Mild cognitive impairment is a condition which typically occurs in 10-20% of people age 65 years and older. MCI is characterized by difficulties with thinking, memory, concentration, reasoning, complex problem-solving, judgment, impulse control, and communication, among other things. Researchers have theorized that TBI activates a neurodegenerative process that may interact with factors such as increased age over time. Additionally, researchers at the UT Southwestern Medical Center recently discovered that a history of TBI with loss of consciousness for more than five minutes made a person 1.2 to 1.3 times more likely to develop MCI, compared to similar persons without a history of TBI.  Those researchers also discovered that a history of TBI created a greater risk of a person showing signs of MCI 2.3 years earlier in life on average, compared to persons with no history of TBI.

The possible long-term effects of TBI can lead to more than MCI alone. MCI is recognized by experts as a precursor to many types of dementia. Dementia is an umbrella term describing a decline in mental ability which is severe enough to interfere with a person’s daily life. Alzheimer’s is recognized as the most common form of dementia. Dementia is a progressive disorder that worsens over time, and negatively affects quality of life, shortens lifespan, and complicates efforts to manage other existing health conditions. In addition to being a risk factor for dementia, MCI can reduce a person’s ability to engage in safety skills and properly monitor their environment.  As a result, TBI sufferers are at an increased risk of death due to subsequent accidental injury. More specifically, persons with a history of TBI are twice as likely to die from an unintentional injury following the TBI, compared to people of similar age, sex, and race.

Due to the unpredictable nature of future disability arising from TBI, many attorneys encounter difficulty in determining a client’s future damages. A person recovering from a TBI may suffer diminished earning capacity even if they re-enter the workforce. Early retirement and diminished productivity are common in TBI sufferers. Some experts have argued that “recovery” is a misnomer since some effects of TBI may only become apparent later in life, or may persist for a lifetime. For these reasons, it can be difficult to calculate future economic losses and the need for future medical care. To avoid undervaluing a client’s claim related to TBI, it is vital for attorneys representing such clients to work with experts, such as life care planners, to properly evaluate a plaintiff’s potential long-term disabilities resulting from the injury, and their need for future care.

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