Traumatic Brain Injury as a Concern for the Aging Population by Adrie Taylor
1.7 million Americans experience traumatic brain injury (TBI) annaully
TBI is a crucial issue among the elder population.
Although everyone is at risk for TBI, the elderly represent the biggest risk group because falls are the number one cause.
Many survivors of TBI may just begin to see the severe repercussions as they enter their senior years.
The Center for Disease Control and Prevention has recognized TBI as an issue for the aging community and has launched an educational campaign specifically for them.
What is TBI? TBI is characterized by a blow to the head which causes loss of consciousness, seizure, amnesia, an abnormal brain scan, and/or a fracture of the skull. Primary Injuries:
possible skull fracture
intracrannial swelling and pressure
brain bleeding and bruising
both axonal and blood vessel damage
axonal damage, in severe cases, can be widespread and cause neuronal death.
What is TBI? cont'd Within hours of the event, secondary injuries, or injuries that are a result of the primaries, may occur. These may include:
Increased brain bleeding
Increased intracrannial pressure
All of these worsening conditions can lead to a risk of stroke. These injuries could be monitored and treated better in the primary stage if one seeks medical attention immediately following the blow, especially for the elderly who are already immunocompromised. left: scan of subdural hematoma
TBI and Memory Loss
One of the first and most classics symptoms of TBI has do with with memory loss, that is amnesia.
This is also a good indicator of how bad the injury: the longer the amnesia, the worse the injury.
The hippocampus is especially vulnerable in a brain injury, which explains why memory loss is so prevalent.
Hippocampal atrophy is a noticeable difference between TBI survivors and healthy individuals.
TBI and Memory Loss Cont'd
TBI has been linked to dementia and Alzheimer's disease.
Contributing to hippocampal atrophy seen in both AD and TBI, amyloid ß plaques are present within hours of TBI, and are a classic sign of AD.
Another correlation between the are abnormal neurofibrilary tangles, which cause nutrient disbursing microtubules in the brain to collapse. This is also seen in dementia pugilistica, a disease notorious in boxers.
Repeated Head Injury in Sports
A survey of retired NFL players resulted in a 19 times greater risk for an early on set of AD.
Dementia pugilistica is a disease which has been known for its prevalence in boxers.
Retired NFL players with repeated head injuries also reported a higher incidence of depression.
Soldiers and TBI As the current generation at war ages, there will be many more cases of elderly TBI survivors due to advances in head protection. In fact, 1 in 4 returning soldiers have reported a TBI during their deployment. Emotional side effects: In a 2008 study, a strong relationship between TBI, depression, and PTSD among the soldiers. Being such a new problem, treating the long term effects of TBI in retired vets is surely a growing concern.
mTBI (concussions) Although victims of severe brain injuries, athletes, and soldiers are at a particularly high risk for TBI, everyone is at risk for mTBI or concussions. It is almost sure that you or someone you know has suffered a concussion at some point. Just because a concussion is a mild brain injury does not mean it does not have long term effects. Silent symptoms may lurk for years. In one study, victims of mTBI performed worse on every cognitive test than the healthy control subjects six years after the time of injury!
Elders and TBI: what to do? Seniors are surely the group that TBI threatens the most. Survivors of early injuries deal with the hallmark memory loss related to AD and dementia. More research on Alzheimer's disease and dementia goes on daily. The more researchers learn, the better we can treat these diseases in elderly victims. Seniors are also the biggest risk group for a new TBI with falls being the number one cause. People over age 75 have the highest rate of TBI-related hosptalization and death. As far as new injuries in old age, prevention is key. The Center for Disease Control suggests things like hand rails, non stick mats,bright lighting, and exercise, among other precautions.
Education and Prevention The wheels are already set in motion for eductaion regarding TBI.
Helmet laws are being passed.
New helmets that record impact are being designed for soldiers.
Posters regarding the relation between TBI and its symptoms are placed in NFL locker rooms.
But we can still do more. Educate your children on helmet safety, educate their coaches on signs and symptoms of brain injury. Help safe guard the homes of elder loved ones, and always encourage anyone who has had a blow to the head to seek medical attention! Thank you and remember, HEADS UP!