The Risk of Traumatic Brain Injury in the Elderly

Traumatic brain injuries (TBIs) affect both the young and old. The elderly population is on the increase due to advancements in healthcare prevention and medical care or treatment. The statistics tell us that the elderly population will double and almost triple over the next 15 years and are at a greater risk for traumatic brain injuries (TBI). Each year, statistics concerned with reported TBIs indicate there are 10,000 deaths, 55,000 hospitalizations and 80,000 emergency room visits. This does not include those injuries that are seen by a primary physician or individuals who never seek treatment. Those individuals, age 75 and older, have the highest rate of hospitalization and death due to TBI[1]. Elderly individuals tend to have slower recovery rates, higher mortality rates and lower functional status at discharge from medical facilities following moderate-to-severe TBI compared to younger individuals[2].

Elderly individuals tend to have less support and fewer personal resources than younger individuals. Sixty percent (60%) of the elderly who experience a mild TBI return home. Thirty (30%) to 50% of the elderly who experience a severe TBI return home. Many elderly are discharged from the hospital to a nursing home[3].

How can the problems caused by a TBI be distinguished from other problems the elderly experience? Changes in an individual who has experienced a TBI may not be present immediately. Some changes become noticeable weeks or months after the injury occurred. There may be a decline in mental capacity or the individual may appear to have sudden signs of dementia. The diagnosis of a TBI is made by a professional who is able to administer testing to determine if an injury has occurred.

The leading causes of TBI in the elderly are falls and car accidents.

Falls are the most common accident for the elderly. Major risk factors that result in a brain injury are increased age, cognitive impairment and alcohol impairment. In addition, medication side effects and adverse drug reactions can also play a role in fall-related accidents. Here are a few guidelines to help reduce the risk of falling.

• Exercise, under a doctor’s supervision, can help improve strength, balance and coordination.
• Home safety can be a major obstacle. The individual’s home should be organized and free from barriers that limit movement.
• Improve lighting and visibility allowing the individual to see any obstacles in his or her way.
• A review of medication for side effects like dizziness or interference with balance should be done with the individual’s doctor.
• Complete an eye exam.

Car accidents are the second leading cause of TBI in the elderly. As an individual ages most often there is a decrease in driving ability. This decrease in ability comes from age-related decline in vision, hearing, motor-reaction time and cognitive ability. An individual who has experienced a TBI has additional challenges. The injury may affect the individual’s ability to respond quickly enough to his or her environment to drive safely. A professional can evaluate these abilities to determine whether or not the individual should be driving.

NeuLife, in Mount Dora, Florida, is a fully accessible residential post-acute program providing superior care and specialized rehabilitation to individuals diagnosed with traumatic brain injury (TBI), spinal cord injury (SCI), traumatic amputations and other catastrophic injuries. Our programs are individualized and tailored to each client based on clinical needs and personal preferences. We focus on the achievement of personal fulfillment, increased independence and successful outcomes.

[1] “Traumatic Brain Injury Facts: TBI & Older Adults,” www.adrc-tae.acl.gov/tiki-download_file.pho>fileld=26393

[2] Deepa Ramanathan, et al, “Epidemiological Shifts in Elderly Traumatic Brain Injury: 18-year Trends in Pennsylvannia,” Journal of Neurotrauma, 29 (2012): 1371-1378

[3] “Traumatic Brain Injury Facts: TBI & Older Adults”