Mild Traumatic Brain Injury Among the Geriatric Population

Abstract

Mild traumatic brain injury (TBI) is an unfortunately common occurrence in the elderly. With the growing population of older adults in the United States and globally, strategies that reduce the risk of becoming injured need to be developed, and diagnostic tools and treatments that may benefit this group need to be explored. Particular attention needs to be given to polypharmacy, drug interactions, the use of anticoagulants, safety issues in the living environment, elder abuse, and alcohol consumption. Low-mechanism falls should prompt health care providers to consider the possibility of head injury in elderly patients. Early and tailored management of our seniors following a mild TBI can provide them with the best possible quality of life. This review will discuss the current literature on mild TBI in the older adult, address gaps in research, and discuss the implications for future care of the older TBI patient.

Head Trauma from Falling Increases Subsequent Emergency Department Visits More Than Other Fall‐Related Injuries in Older Adults

“…Many of the ED revisits were due to problems from the injuries sustained, including some with headache in the head trauma group, which suggests that these individuals may be struggling with their symptoms after an injury. Mild head trauma has been found to be an independent predictor of mortality in older adults and is associated with symptoms of major depressive disorder and poor cognition and functional status . Older adults also may have slower recovery from mild traumatic brain injury than younger individuals .…”

“…Mild head trauma has been found to be an independent predictor of mortality in older adults 19 and is associated with symptoms of major depressive disorder and poor cognition and functional status. 20 Older adults also may have slower recovery from mild traumatic brain injury than younger individuals. 21 Traumatic brain injury can be associated with gait imbalances 22 and mental status changes, which could predispose to further falls.…”

Increased Rates of Mild Traumatic Brain Injury Among Older Adults in US Emergency Departments, 2009-2010

“…5,7 Diagnosis of mild TBI is difficult due to the absence of well-defined clinical criteria and among older adults is further complicated by the presence of comorbid conditions, medication use, and pre-injury cognitive impairment which can disguise symptoms of mild TBI. 8-10 Furthermore, age-related increases in intracranial space and anticoagulant use make bleeding more likely among older adults while at the same time decreasing the likelihood that GCS scores would indicate serious injury. 11,12 Consequently, mild TBI among older adults is most likely underdiagnosed.…”

Risk of Mortality in Individuals with Hip Fracture and Traumatic Brain Injury

“…Falls in older adults are also the primary cause of traumatic brain injury (TBI), which is associated with cognitive impairment, disability, and mortality . TBI resulted in more than 600,000 emergency department visits, hospitalizations, and deaths in older adults in the United States in 2013 .…”

“…2,4,5 Falls in older adults are also the primary cause of traumatic brain injury (TBI), which is associated with cognitive impairment, disability, and mortality. [6][7][8][9][10][11][12][13] TBI resulted in more than 600,000 emergency department visits, hospitalizations, and deaths in older adults in the United States in 2013. 11 More than 70% of TBIs are mild and can even occur without direct head impact, being caused by the rapid acceleration and deceleration that occur during a fall.…”