Scott Krist Apr 08, 2025
Personal Injury
long term effects of TBI

A traumatic brain injury (TBI) can happen in a split second, but the long-term effects can last a lifetime. According to the Centers for Disease Control and Prevention (CDC), TBI is a major cause of death and disability in the United States, with over 69,000 TBI-related deaths reported in 2021—approximately 190 deaths every day. The tragedy is that traumatic brain injuries are often severe and life-altering despite advances in medical science.

If you’re experiencing long-term effects of TBI, understanding what you may face is essential. Every injury is different, but medical research provides insight into what many TBI survivors experience. With knowledge and proper support, you can better navigate the challenges ahead.

Higher Risk of Cognitive Decline and Dementia

Just like a cut or broken bone, when the brain attempts to heal, it may not return to its exact pre-injury functionality. Multiple studies show that moderate and severe TBIs increase the risk of dementia between 2 and 4-fold. Those with a history of moderate TBI had a 2.3 times greater risk of developing Alzheimer’s than seniors without head injury history, while those with severe TBI had a 4.5 times greater risk.

However, research findings about mild TBIs are less definitive. Single mild TBIs don’t appear to increase cognitive decline and dementia risk significantly. But according to the Alzheimer’s Association, repeated mild traumatic brain injuries, such as those experienced in contact sports, may increase the risk of developing traumatic encephalopathy syndrome or specific brain changes associated with chronic traumatic encephalopathy (CTE).

A recent nationwide longitudinal cohort study published in 2023 found that despite slightly higher frequencies of mild cognitive impairment or dementia at baseline in those with multiple TBIs, researchers did not find an association between TBI characteristics and longitudinal neurocognitive decline across various cognitive domains over 3-5 years of follow-up. This highlights the complex nature of TBI outcomes and emphasizes the need for individual assessment.

Mortality Risk Following Traumatic Brain Injuries

According to data from the Traumatic Brain Injury Model Systems (TBIMS), the largest longitudinal TBI database in the world with over 18,000 participants, mortality rates after TBI are significant. Approximately 22% of traumatic brain injury victims die within five years of their injury. This sobering statistic underscores the serious nature of these injuries and their potential long-term consequences.

The risk factors for mortality after TBI include the severity of the initial injury, age at injury, presence of other injuries, and development of secondary complications. Early intervention and comprehensive care are crucial to improving survival rates.

Disabilities Due to Traumatic Brain Injuries

Disabilities Due to Traumatic Brain InjuriesStudies show that TBIs frequently lead to significant disabilities. While evidence indicates that earlier initiation of rehabilitation results in the greatest functional improvements, even patients who start rehabilitation therapy later after injury can still make tremendous strides in recovery.

For patients with severe TBI who were unable to follow commands at admission to rehabilitation, two-thirds were following commands by discharge, and by 5 years, independent functioning ranged from 56% to 85%, depending on the functional domain. Even for those unable to follow commands by rehabilitation discharge, independence at 5 years ranged from 19% to 36%.

Disabilities can vary widely depending on the injury location and severity. You might experience:

  • Impaired motor functions affecting mobility
  • Vision or hearing impairments
  • Speech and language difficulties
  • Cognitive challenges with memory, attention, or problem-solving
  • Emotional and behavioral changes

These physical impairments can significantly affect quality of life and ability to participate in daily activities, work, and social interactions.

Financial Impact of Traumatic Brain Injuries

The economic burden of TBI is substantial. The CDC estimated that the economic cost of TBI was around $76.5 billion in 2010, including both direct and indirect treatment costs. Many studies have found that the total societal cost far exceeds the direct medical costs. One cost-benefit analysis estimated the medical savings to be $11,280 per patient compared to the estimated cost to society of $164,951.

According to the CDC, the average medical cost of a fatal TBI is approximately $41,000, while non-fatal TBIs result in thousands of dollars in medical expenses and lost wages. The Brain Association of Missouri reports that the cost of care for the average TBI patient is around $151,000 in the first year after injury.

Financial challenges typically include:

  • Immediate medical care and hospitalization
  • Rehabilitation services
  • Long-term therapy and treatment
  • Potential need for specialized equipment
  • Home modifications for accessibility
  • Lost income due to inability to work
  • Costs of personal care assistance

Effective Rehabilitation Options

Effective Rehabilitation OptionsBrain injury rehabilitation involves channeling the body’s natural healing abilities and the brain’s relearning processes for optimal recovery, while also teaching compensatory strategies for permanently altered abilities. The focus is enabling individuals to perform activities of daily living safely and independently.

Studies have shown that the majority of recovery from TBI occurs within two years of the injury, making timely rehabilitation crucial. Rehabilitation should ideally start at admission and continue from intensive care through community reintegration for moderate to severe TBI patients. Even mild TBI patients should receive long-term follow-up as some develop chronic cognitive problems or fatigue over time.

Rehabilitation options include:

  1. Acute Rehabilitation: Early intervention in a hospital setting focused on regaining basic daily functions
  2. Post-Acute Rehabilitation: More intensive therapy (often 6+ hours daily) at specialized facilities
  3. Sub-Acute Rehabilitation: Less intensive services over a longer period for those who need extended recovery time
  4. Outpatient Rehabilitation: Continued therapy after discharge from inpatient care
  5. Community-Based Rehabilitation: Support services to help with reintegration into daily life

Cognitive rehabilitation shows promising results, with 43 studies reporting significant effects of cognitive interventions across various domains. Effective approaches include individualized sessions (used in 83% of studies) with an integrative cognitive approach (48%).

Taking Action After a TBI

If you or a loved one has suffered a traumatic brain injury, here are important steps to consider:

  1. Seek appropriate medical care: Ensure you’re receiving the right level of treatment for your injury severity.
  2. Explore rehabilitation options: Research facilities that specialize in brain injury rehabilitation.
  3. Understand your insurance coverage: Review what services are covered and for how long.
  4. Connect with support resources: Organizations like the Brain Injury Association of America provide valuable information and community support.
  5. Consider legal consultation: If your injury resulted from someone else’s negligence, you may have options for compensation to cover costs, lost wages, diminished earning capacity and pain and suffering.
  6. Focus on overall wellness: Proper nutrition, adequate rest, and following medical recommendations can support recovery.

Remember that recovery from TBI is often a marathon, not a sprint. With proper support, many TBI survivors can achieve significant improvements in function and quality of life.

Resources for TBI Survivors and Families

References

  1. Centers for Disease Control and Prevention. (2024). Facts about TBI. Retrieved from https://www.cdc.gov/traumatic-brain-injury/data-research/facts-stats/index.html
  2. Alzheimer’s Association. (2024). Traumatic Brain Injury. Retrieved from https://www.alz.org/alzheimers-dementia/what-is-dementia/related_conditions/traumatic-brain-injury
  3. Dementia Resulting From Traumatic Brain Injury: What Is the Pathology? (2013). Archives of Neurology, 70(3), 300-308. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3716376/
  4. Schaffert, J., LoBue, C., Chiang, H.S., Peters, M.E., Hart, J., & Cullum, C.M. (2024). Traumatic Brain Injury Characteristics Are Not Related to Neurocognitive Decline in Older Adults: A Nationwide Longitudinal Cohort Study. Archives of Clinical Neuropsychology, 39(3), 325-334. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC11042919/
  5. Traumatic Brain Injury Model Systems National Database. (2023). Retrieved from https://odphp.health.gov/healthypeople/objectives-and-data/data-sources-and-methods/data-sources/traumatic-brain-injury-model-systems-national-database-tbims-ndb
  6. Whyte, J., Nakase-Richardson, R., Hammond, F.M., McNamee, S., Giacino, J.T., Kalmar, K., et al. (2013). Functional outcomes in traumatic disorders of consciousness: 5-year outcomes from the National Institute on Disability and Rehabilitation Research Traumatic Brain Injury Model Systems. Archives of Physical Medicine and Rehabilitation, 94(10), 1855-1860.
  7. National Institute of Neurological Disorders and Stroke. (2024). Traumatic Brain Injury (TBI). Retrieved from https://www.ninds.nih.gov/health-information/disorders/traumatic-brain-injury-tbi
  8. Humphreys, I., Wood, R.L., Phillips, C.J., & Macey, S. (2013). The costs of traumatic brain injury: a literature review. ClinicoEconomics and Outcomes Research, 5, 281-287. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC3699059/
  9. Brain and Spinal Cord. (2018). Medical Expenses for a Traumatic Brain Injury. Retrieved from https://brainandspinalcord.org/medical-expenses-traumatic-brain-injury/
  10. Centers for Disease Control and Prevention. (2010). Economic Burden of TBI. Retrieved from https://www.cdc.gov/traumaticbraininjury/
  11. Brain Injury Association of America. (2023). Brain Injury Rehabilitation. Retrieved from https://biausa.org/brain-injury/about-brain-injury/treatment/brain-injury-rehabilitation
  12. Koubaa, W., Moussa, S., Mpoame, O.G.T., & Djuissi, D.D. (2023). Early neuro-rehabilitation in traumatic brain injury: the need for an African perspective. BMC Medicine, 21, Article 319. Retrieved from https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-023-03009-z