What is Dementia Pugilistica?

D. Jeffress

Dementia pugilistica is a disorder that develops over several years due to multiple episodes of head trauma. Frequent concussions can lead to permanent brain damage, resulting in progressively worsening mental faculties. The condition is very common in professional boxers, or pugilists, as its name suggests. There is no cure for dementia pugilistica, though medications and therapy can help to slow the rate of cognitive degeneration and help patients learn to live with the disease.

Head trauma occurs often during the course of a professional hockey game.
Head trauma occurs often during the course of a professional hockey game.

A person who has dementia pugilistica may display a range of mental and physical symptoms. The disorder can inhibit an individual's ability to process written or spoken language, concentrate on tasks, and remember events. Some people experience psychotic episodes, mood swings, and unpredictable behavior changes. Physical symptoms are often similar to the ones seen with Parkinson's disease, and can include hand tremors, speaking difficulties, and loss of motor movement coordination.

Damage of the cerebellum may lead to dementia pugilistica.
Damage of the cerebellum may lead to dementia pugilistica.

Symptoms of dementia pugilistica are not exclusively found in boxers. Athletes who play contact sports such as hockey and football are also at risk of developing the condition. Engaging in fast-paced, high-impact activities such as skiing and skateboarding may result in dementia pugilistica if enough falls are taken. Repetitive concussions do not always manifest as dementia pugilistica. It is likely, however, that multiple cerebral contusions, damage to the cerebellum, and massive neuron death will begin to cause problems within about a decade.

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Even skateboarders can suffer from dementia pugilistica if they fall and hit their heads many times.
Even skateboarders can suffer from dementia pugilistica if they fall and hit their heads many times.

A doctor can diagnose dementia pugilistica by reviewing a patient's medical history, evaluating present symptoms, and performing imaging tests. Computerized tomography scans are used to look for physical signs of brain and brain stem damage. Electroencephalograms and other electric brain-wave monitoring tools can help a neurologist determine the severity of a patient's condition.

Contact sports, like football, can increase a player's risk of developing dementia pugilistica.
Contact sports, like football, can increase a player's risk of developing dementia pugilistica.

Treatment measures are determined largely on a case-by-case basis. A doctor usually prescribes medications to help prevent seizures, tremors, muscle spasms, and other physical manifestations of the disorder. Antipsychotic drugs and sedatives can be helpful for patients who suffer from behavioral swings, hallucinations, and concentration problems. Many patients participate in ongoing speech and physical therapy to help them maintain the highest degree of independence possible in their daily lives.

Dementia pugilistica is much easier to prevent than it is to treat. Wearing a helmet is essential when playing contact and action sports, riding motorcycles, and engaging in other activities where head trauma is likely. Due to the high incidence of dementia in boxers, many leagues around the world are requiring their athletes to wear protective headgear in practice as well as in actual matches.

Dementia pugilistica is very common in professional boxers.
Dementia pugilistica is very common in professional boxers.

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Discussion Comments


I am doing a report on this disease right now and it is so sad! I personally think we either need to get better protection for the players or completely ban the sport!


@stl156 - That is a very sad story and I hope it is only a temporary thing that your friend is going through.

I like how in high schools nowadays they are taking more precautions as far as concussions go. They have instituted rules where you can be ejected for leading with the helmet and have really cracked down on helmet to helmet hits in recent years.

I have also seen that if a student had a sign of a concussion they are immediately taken out of the game and are forced to sit one game.

I graduated in 2006 and even then nothing like that was thought to happen in regards to concussions. It is amazing how far it has come in recent years, the awareness of concussions and the mutual fears that people have of it.


@Emilski - Despite whatever efforts and research they have and obtain they can never prevent concussions entirely or the severity of them.

One bad concussion can have a long term effect on someone as well as many concussions.

I know someone who played football in college who had six concussions and has gotten another in an accident recently and being in his late twenties he already has trouble remembering things once in awhile.

It is very odd and a little frightening to see the kind of damage the concussions have done. Once in awhile he will tell a story then five minutes later tell the exact same story without remembering he had told it earlier. He does not do this all the time, only once in awhile, but it is definitely something to take notice of and I am afraid that he will have a form of dementia in the future.


@cardsfan27 - That is a phenomenal story and I can say that if that happened nowadays the coaches would be fired and never be allowed to coach again.

I will say I absolutely agree with you as far as research goes. There has been so much that has been discovered in the last five years connecting concussions with chronic problems like dementia. The NFL seems to be the main focus on which to study players that receive concussions to figure out long term effects.

I remember hearing that there was this one lineman that retired about five years ago and is in his early forties and he is beginning to suffer from Dementia Puglistica. He was estimated to have had between thirty and forty concussions in his lifetime playing football and he is paying for it now.

He as well as many other football players with concussions are being studied so they can figure out the severity of concussions and maybe figure out a way to gauge them so they can prevent players from having long term problems.


In recent years there have been studies done on football players that have connected concussions to dementia.

I remember hearing stories from football players in my town playing through concussions and not remembering anything about the game. On guy I know told me that he got concussed early in a playoff game and still played every play of the game on both offense and defense as well as special teams. He does not remember anything about the game to this day and even was not allowed to drive home after.

I was a little disgusted after hearing this. Apparently the coaches thought he was well enough to continue playing a football game, but not well enough to drive. Nowadays this would never happen due to laws and guidelines that have been passed concerning taking people out of the games when they receive concussions.


When we were younger and took our kids skiing, none of us ever wore helmets. This changed pretty quickly after one of our sons was hurt in a ski accident.

We are thankful he didn't suffer more than a concussion, but this scared both him and us. Since then it has not been hard to get our kids to wear a helmet when they ski.

Even though it doesn't take long to feel normal after a mild concussion, I think there is still trauma to the brain which can have lasting effects.

I know a lady who has early onset dementia, and it is so sad to see her slowly decline. Her dementia seems to be more hereditary, but the effects of something like this really makes a difference for the entire family.


One of our friends have a son who was involved in a lot of contact sports in high school. At one point, after more than one concussion, they advised him to quit playing these sports.

This is something that is really hard for a high school student to understand how this can affect their life later on down the road.

There is such great emphasis put on sports in high school, and this was something he didn't want to hear, and continued to play.

Because of the head trauma he received, he has a much greater chance of getting something like dementia pugilistica in the future. He is still young and as not shown any dementia signs yet, but many times this doesn't show up for a long time.

It will be interesting to see if he lets his boys participate in the same sports he did when he was in high school.

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