The Overlap: ACEs, TBI, & Dementia

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Traumatic brain injuries are a public health issue of increasing concern as a significant cause of disability and death in children. According to the CDC, traumatic brain injury (TBI) results in disturbed brain functioning due to a “bump, blow, or jolt to the head.” Shaken baby syndrome is one of the well-documented forms of childhood abuse, which occurs when an adult shakes a baby in anger or frustration. As a result, children may suffer some seizures, delayed development, poor eyesight or blindness, and in some cases, death. TBI can impact a child’s social, cognitive, and sexual development, causing the individual to display “challenging” behaviors in adulthood.

Adverse childhood experiences (ACEs) cause brain impairment similar to impairment caused by TBI. The study of ACES has brought awareness to how physical and mental health is impacted in adulthood and brings a deeper understanding of the criminal statistics due to childhood mistreatment or TBI.

With each additional ACE, a child is at an increased risk of developmental, physical, and mental health challenges. This is due to executive functioning being impaired, causing a loss of impulse control, problem-solving, and decision-making. Both ACES and TBI have been linked to pedophilic interests and other inappropriate sexual behaviors.

Between 3.5 to 9% of individuals display sexually offensive behavior post-TBI, and sexual offenders report having experienced many ACES. This informs the barriers that may be present in treatment, as adulthood behaviors may stem from childhood adversity, as society focuses on punishing and not rehabilitating those with brain impairment. Understanding the research on brain trauma and ACEs helps us assist in transitioning our mentalities from “What is wrong with you?” To “What happened to you?”

The Relationship Between Dementia and ACES

ACEs change the structure and functioning of the brain and impact an individual throughout their life. A study in Japan has found that individuals reporting 3 or more ACEs are at the highest risk of developing dementia. An American study found similar results being able to estimate the probability of positive dementia screening with adults aged 64-74 who had experienced 4 or more ACEs.

ACEs impair memory and cognition, and early life stress has also been linked to chronic illness.

It's essential to recognize that while symptomatic overlap exists between ACEs, TBI, and dementia, their underlying causes and trajectories differ. Moreover, not all individuals with a history of ACEs or TBI will develop dementia, and vice versa.

Chart Observation: Symptoms OVERLAP - Traumatic Brain Injury (TBI), Adverse Childhood Experiences (ACEs) & Dementia

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With that sentiment in mind, our audience has handpicked 10 films exploring themes surrounding brain injury and disorders, offering education and inspiration. These movies cover a range of topics, including TBI, Alzheimer’s, stroke, concussion, aphasia, and beyond.

1. "The Crash Reel" (2013, Content Rating: PG) – Elite snowboarder Kevin Pierce's journey after a traumatic brain injury from a slope accident showcases adaptation to a "new normal."
2. "The Diving Bell and The Butterfly" (2007, Content Rating: PG-13) – True story of Jean-Dominique Bauby, a stroke survivor who communicates by blinking his left eye, leading to a remarkable book and film accolades.
3. "Concussion" (2015, Content Rating: PG-13) – Will Smith portrays Dr. Bennet Omalu, who exposes brain damage in retired NFL players, known as CTE.
4. "Regarding Henry" (1991, Content Rating: PG-13) – Harrison Ford stars as a Manhattan attorney rebuilding his life after a shooting-induced brain injury.
5. "The Theory of Everything" (2014, Content Rating: PG-13) – Eddie Redmayne portrays physicist Stephen Hawking, chronicling his relationship with his wife amidst ALS diagnosis.
6. "Away From Her" (2006, Content Rating: PG-13) – Julie Christie shines in this Oscar-nominated role as Fiona, who chooses to enter a care facility due to Alzheimer's.
7. "My Beautiful Broken Brain" (2016, Content Rating: PG-13) – Lotje Sodderland's documentary showcases her emotional journey after a stroke at 34, capturing the challenges of dysphasia and apraxia.
8. "Welcome To Marwen" (2018, Content Rating: PG-13) – Steve Carell portrays Mark Hogancamp, using art therapy to cope with memory loss after a brain injury.
9. "Still Alice" (2014, Content Rating: PG-13) – Julianne Moore stars as a professor facing early-onset Alzheimer's disease, shedding light on its impact.
10. "Caris’ Peace" (2010, Content Rating: PG) – Caris Corfman's story of overcoming memory loss from a brain tumor, capturing her triumphant return to the stage.

Article Written and Summarized by Volunteer Guest Writer & Graduate Students Andrea Vogeler, edited by C. Stanford and H. Sandifer

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References
Blair, C., & Raver, C. C. (2012). Child development in the context of adversity: Experiential canalization of brain and behavior. American Psychologist, 67(4), 309–318. https://doi.org/10.1037/a0027493
Felitti, V. J., & Anda, R. F. (2010). The relationship of adverse childhood experiences to adult medical disease, psychiatric disorders, and sexual behavior: Implications for healthcare. In R. Lanius, E. Vermetten, & C. Pain (Eds.), The impact of early life trauma on health and disease: The hidden epidemic (pp. 77–87). Cambridge University Press.
Blasingame. (2018). Traumatic Brain Injury and Sexually Offensive Behaviors. Journal of Child Sexual Abuse, 27(8), 972–977. https://doi.org/10.1080/10538712.2018.1510454.
Schickedanz, Jennings, L. A., & Schickedanz, A. (2022). The Association Between Adverse Childhood Experiences and Positive Dementia Screen in American Older Adults. Journal of General Internal Medicine : JGIM, 37(10), 2398–2404. https://doi.org/10.1007/s11606-021-07192-8
https://www.asha.org/practice-portal/clinical-topics/pediatric-traumatic-brain-injury/
What Happened To You - Seeing this from a research and scientific environmental predisposition allows you to humanize the person.
https://constanttherapyhealth.com/brainwire/10-top-films-about-brain-injury-and-brain-disorders/