A recent study conducted by UC San Francisco alongside the San Francisco VA Health Care System has revealed that approximately 13% of older adults are diagnosed with traumatic brain injury (TBI). This figure highlights the vulnerability of this population to such injuries. Typically, these injuries arise from falls from ground level. The research involved monitoring around 9,200 Medicare enrollees, who had an average age of 75 at the beginning of the study. The findings, which will be published in JAMA Network Open on May 31, 2024, present some surprising contrasts to earlier studies focused on younger demographics.
Interestingly, the study found that being female, white, in better health, and of a higher socio-economic status increased the risk of TBI among older adults. This marks a departure from earlier research, which typically found higher incidences of TBI in males, non-whites, and those from lower socio-economic backgrounds. In this study, of the 1,148 participants who experienced a TBI, 64% were female, and 89% were white. Furthermore, a significant portion of these individuals were among the wealthiest, with 31% belonging to the highest wealth quartile.
The researchers, led by Erica Kornblith, PhD, of the UCSF Department of Psychiatry and the San Francisco VA Health Care System, speculated that the more active lifestyles of healthier, wealthier seniors might expose them to more significant risks for TBI. Their findings also suggested that older adults with more robust health at the study’s outset were more likely to engage in activities that could lead to falls, the predominant cause of TBI in this group. Conversely, those who were less mobile or had cognitive impairments had fewer opportunities to sustain such injuries.
This study’s findings challenge some established notions about the demographic patterns of TBI in older people, highlighting that even relatively healthier and wealthier people are not immune to these risks. Moreover, the results underscore the importance of developing targeted guidelines for post-discharge care and ongoing research into preventing repeat injuries and TBI-related dementia among this growing segment of the population.
Senior author Raquel Gardner, MD, emphasized the need for evidence-based strategies to manage the care of the large number of elderly individuals with TBI, particularly in light of their potential to develop severe conditions such as dementia, Parkinson’s disease, seizures, cardiovascular disease, and psychiatric conditions including depression and anxiety.
The implications of these findings are significant, particularly at a time when physical activity is strongly advocated as a means to mitigate or delay the onset of dementia in the elderly. While the benefits of physical activity are well-documented in terms of neuroprotection, this study highlights the need for balanced approaches that enhance safety and reduce the likelihood of falls among older adults, especially as they age and experience physical or cognitive decline. This nuanced understanding of TBI risk factors among older adults calls for a recalibration of health and safety protocols to better accommodate the complexities of ageing in today’s sociopolitical and healthcare environments.
More information: Erica Kornblith et al, Incidence of Traumatic Brain Injury in a Longitudinal Cohort of Older Adults, JAMA Network Open. DOI: 10.1001/jamanetworkopen.2024.14223
Journal information: JAMA Network Open Provided by University of California – San Francisco
