Health problems may predict traumatic brain injuries in older adults

Traumatic brain injury (TBI), a leading cause of death and disability, has become so common in recent times that it has been called a "silent epidemic." And because older adults are more likely to suffer TBI, have worse outcomes, and are less likely to survive their injury than younger adults, older adults are considered a "silent population" within this epidemic.

In a study published in the Journal of the American Geriatrics Society, researchers set out to learn about the risk factors for TBI in older adults so that healthcare professionals can develop strategies to prevent these types of injuries whenever possible. The current study is believed to be the first to evaluate TBI-associated risk factors in older adults, said the researchers.

The researchers studied participants from the Adult Changes in Thought (ACT) study. They looked at 4,004 people without dementia who were 65-years-old and older. None of the participants had sustained a prior TBI when they joined the study. The people were followed every two years for an average of 7.5 years. During each visit, researchers interviewed the participants and asked whether they had had an injury severe enough to cause a loss of consciousness. The researchers also collected other data at each visit, including information on the state of the participant's health, depression symptoms, alcohol use, and whether or not they were physically active.

Researchers measured the participants' cognitive function and physical performance. They also assessed their ability to complete activities of daily living (ADL) such as bathing, dressing, walking around the house, getting out of bed or a chair, feeding themselves, and using a toilet.

The researchers reported that people who had any of the following were at higher risk of having a TBI:

• Vascular health conditions (or conditions affecting the heart's major blood vessels)
• Depression
• Difficulty performing ADLs
• More than one chronic disease

However, having a sedentary lifestyle or self-reported alcohol problems, lower cognitive functioning, or markers for Alzheimer's disease were not linked to having a TBI. In addition, people who suffered a TBI and who had vascular health problems or difficulty with ADLs were at greater risk for death.

The researchers concluded that their results highlight the need to target prevention efforts that could help address TBI, especially for people at the greatest risk.

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This summary is from "Health Problems Precede Traumatic Brain Injury in Older Adults." It appears online ahead of print in the April 2016 issue of the Journal of the American Geriatrics Society. The study authors are Kristen Dams-O'Connor, PhD; Laura E. Gibbons, PhD; Alexandra Landau, BA; Eric B. Larson, MD, MPH; and Paul K. Crane, MD, MPH.

About the Health in Aging Foundation

This research summary was developed as a public education tool by the Health in Aging Foundation. The Foundation is a national non-profit established in 1999 by the American Geriatrics Society to bring the knowledge and expertise of geriatrics healthcare professionals to the public. We are committed to ensuring that people are empowered to advocate for high-quality care by providing them with trustworthy information and reliable resources. Last year, we reached nearly 1 million people with our resources through HealthinAging.org. We also help nurture current and future geriatrics leaders by supporting opportunities to attend educational events and increase exposure to principles of excellence on caring for older adults. For more information or to support the Foundation's work, visit http://www.HealthinAgingFoundation.org.

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