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When OTs Wore White Shoes

Cycling Safely

Published September 30, 2015 2:58 PM by Debra Karplus

My friend died recently. I don't know the official cause of death, but I definitely know that he had some dementia that became totally debilitating during the last years of his life - so debilitating that he couldn't function on his own or even in an assisted living facility. He spent his final years in a long term care facility near his daughter's home, far away from anything familiar. 

I had met him in the late 1980s when he was in his fifties. He was at the "top of his game" back then and had recently retired from the prestigious position of being head physician at a large city hospital. It broke my heart watching his mental abilities erode, first in small, subtle ways like the absentmindedness that all of us experience occasionally; and then later, bigger, more serious memory lapses that jeopardized his judgment about personal safety and, ultimately, the inability to perform even the most simple daily tasks.

He had shared with me that he'd been in a bad bicycle wreck not too long before his retirement while not wearing a helmet, and may have suffered a concussion but he was not really sure. A concussion is described as a temporary and mild form of a traumatic brain injury (TBI). Symptoms include memory loss and confusion. 

Statistics show that concussion symptoms may not go away and can lead to some form of dementia. Joe didn't say if his retirement was related to the concussion, and I didn't ask. But as time went on, I certainly wondered if there might have been a connection between the concussion and his dementia later in life.

Coincidentally, one of Joe's good friends, a University professor, had a similar demise, and he too had been in a serious bike wreck. In his case, he was riding along with no helmet and the tire of his bike got caught in the slit in a street sewer, dramatically throwing him off the bike and onto his head.

When I was growing up in the 1950s, no one ever wore a bicycle helmet. We rode our bikes all over the place, took an occasional tumble, but never anything serious. Mostly we rode on the sidewalk and no one ever scolded us for that, but maybe because we were just kids.

Online I discovered that bicycle helmets weren't even around until about 1975. My children were of bike-riding age in the mid-1980s, and frankly, I don't even remember ever getting them bike helmets. Shame on me! Happily, they never suffered more than a scraped knee from careless riding.

According to, most serious bicycle accidents, including the fatal ones, cause injury to the head. But they claim that the risk of a head injury can be reduced by about 85% by wearing a helmet. And the helmet must be properly fitted and replaced about every five years or so.

What clinical or personal experience have you as OTs had with head injuries related to a bicycle accident?

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Thanks for reading and commenting, Kevin k.

Debbie , Author October 5, 2015 10:10 AM

The 85% reduction in risk for serious head injuries is pretty well documented, though it doesn't quite translate into 85% reduction in risk of death (perhaps because many of the deaths are caused by multiple injuries, and eliminating one of them is not enough).

The "replace every five years" guideline is not backed by any research I could find—it seems to be an industry-sponsored guideline to sell more helmets.

Kevin September 30, 2015 11:16 PM
Santa Cruz CA

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