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11d - Traumatic brain injury in older adults

from Section II - Disorders

Published online by Cambridge University Press:  07 May 2010

By
Felicia C. Goldstein  and
Harvey S. Levin
Edited by
Jacobus Donders  and
Scott J. Hunter
Jacobus Donders
Affiliation:
Mary Free Bed Rehabilitation Hospital
Scott J. Hunter
Affiliation:
University of Chicago
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Summary

Introduction

Traumatic brain injury (TBI) in older adults poses a critical health problem, a statement which is supported by epidemiological studies indicating that persons aged 65 years and older are especially vulnerable. In the USA, the rate of TBI-related emergency room visits, hospitalizations, and deaths for the period 1995–2001 was 267.4/100,000 in persons aged 65–74 years. The figure for those 75 years and older dramatically increased to 659.1/100,000, and this group was found to have the highest rate of TBI-related hospitalizations and deaths compared to any other ages [1]. Analysis of data from a Centers for Disease Control and Prevention 15-state TBI surveillance system indicated that persons 85 years and older were twice as likely to be hospitalized as those 75–84 years, and more than 4-times as likely as those 65–74 years [2]. The above statistics are coupled with shifts in the percentage of older persons in the USA. Thirty-five million people were 65 years and older in the year 2000, representing a 12% increase over the past decade. This figure is projected to rise to 53 million in the year 2020, with the elderly comprising over 20% of the US population by the year 2030 [3].

In this chapter, we present research findings concerning the functional, cognitive, and emotional outcomes from TBI sustained in older adults.

Type
Chapter
Information
Principles and Practice of Lifespan Developmental Neuropsychology , pp. 345 - 356
Publisher: Cambridge University Press
Print publication year: 2010

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References

Langlois, JA, Rutland-Brown, W, Thomas, KE. Traumatic brain injury in the United States: Emergency department visits, hospitalizations, and deaths. Atlanta, Georgia: Centers for Disease Control and Prevention, National Center for Injury Control and Prevention; 2006.Google Scholar
Coronado, VG, Thomas, KE, Sattin, RW, Johnson, RL. The CDC Traumatic Brain Injury Surveillance System: Characteristics of persons aged 65 years and older hospitalized with a TBI. J Head Trauma Rehabil 2005;20:215–28.CrossRefGoogle ScholarPubMed
,United States Census Bureau, The 65 Years and Over Population. U.S. Department of Commerce, Economics, and Statistics Administration; 2000.Google Scholar
Alberico, AM, Ward, JD, Choi, S, Marmarou, A, Young, HF.Outcome after severe head injury: relationship to mass lesions, diffuse injury, and ICP course in pediatric and adult patients. J Neurosurg 1987;67:648–56.CrossRefGoogle ScholarPubMed
Dikmen, SS, Ross, BL, Machamer, JE, Temkin, NR.One year psychosocial outcome in head injury. J Int Neuropsych Soc 1995;1:67–77.CrossRefGoogle ScholarPubMed
Gomez, PA, Lobato, RD, Boto, GR, Lama, A, Gonzalez, PJ, Cruz, J.Age and outcome after severe head injury. Acta Neurochir 2000;142:373–80.Google ScholarPubMed
Jennett, B, Teasdale, G, Braakman, R, Minderhoud, J, Knill-Jones, RPredicting outcome in individual patients after severe head injury. Lancet 1976;1:1031–4.CrossRefGoogle ScholarPubMed
Katz, DI, Alexander, MP. Traumatic brain injury: predicting course of recovery and outcome for patients admitted to rehabilitation. Arch Neurol 1994;51:661–70.CrossRefGoogle ScholarPubMed
Mosenthal, AC, Lavery, RF, Addis, M, Kaul, S, Ross, S, Marburger, R, et al. Isolated traumatic brain injury: age is an independent predictor of mortality and early outcome. J Trauma 2002;52:907–11.Google ScholarPubMed
Mosenthal, AC, Livingston, DH, Lavery, RF, Knudson, MM, Lee, S, Morabito, D, et al. The effect of age on functional outcome in mild traumatic brain injury: 6-month report of a prospective multicenter trial. J Trauma 2004;56:1042–8.CrossRefGoogle ScholarPubMed
Pennings, JL, Bachulis, BL, Simons, CT, Slazinski, T. Survival after severe brain injury in the aged. Arch Surg 1993;128:787–93.CrossRefGoogle ScholarPubMed
Pentland, B, Jones, PA, Roy, CW, Miller, JD. Head injury in the elderly. Age Ageing 1986;15:193–202.CrossRefGoogle ScholarPubMed
Rothweiler, BR, Temkin, NR, Dikmen, SS. Aging effect on psychosocial outcome in traumatic brain injury. Arch Phys Med Rehabil 1998;79:881–7.CrossRefGoogle ScholarPubMed
Susman, M, DiRusso, SM, Sullivan, T, Risucci, D, Nealon, P, Cuff, S, et al. Traumatic brain injury in the elderly: Increased mortality and worse functional outcome at discharge despite lower injury severity. J Trauma 2002;53:219–24.CrossRefGoogle ScholarPubMed
Vollmer, DG, Torner, JC, Jane, JA, Sadornic, B, Charles-Bois, D, Eisenberg, HM. Age and outcome following traumatic coma: why do older patients fare worse? J Neurosurg 1991;75:S37–49.Google Scholar
Clifton, GL, Miller, ER, Choi, SC, Levin, HL, McCauley, S, Smith, KR, et al. Hypothermia on admission in patients with severe brain injury. J Neurotrauma 2002;19:293–301.CrossRefGoogle ScholarPubMed
Teasdale, G, Jennett, B. Assessment of coma and impaired consciousness: a practical scale. Lancet 1974;2:281–4.Google ScholarPubMed
Jennett, B, Bond, MR. Assessment of outcome after severe brain damage. Lancet 1975;1:480–4.CrossRefGoogle ScholarPubMed
Granger, CV, Hamilton, BB. UDS report. The uniform data system for medical rehabilitation report of first admissions for 1992. Am J Phys Med Rehab 1992;71:108.CrossRef
Ulvik, A, Wentzel-Larsen, T, Flaatten, H. Trauma patients in the intensive care unit: short- and long-term survival and predictors of 30-day mortality. Acta Anaesthesiol Scand 2007;51:171–7.CrossRefGoogle Scholar
Ushewokunze, S, Nannapaneni, R, Gregson, BA, Stobbart, L, Chambers, IR, Mendelow, AD. Elderly patients with severe head injury in coma from the outset – has anything changed? Brit J Neurosurg 2004;18:604–7.CrossRefGoogle ScholarPubMed
Kotwica, Z, Jakubowski, JK. Acute head injuries in the elderly. An analysis of 136 consecutive patients. Acta Neurochir 1992;118:98–102.CrossRefGoogle ScholarPubMed
Ross, AM, Pitts, LH, Kobayashi, S.Prognosticators of outcome after major head injury in the elderly. J Neurosci Nursing 1992;24:88–93.CrossRefGoogle ScholarPubMed
Adhiyaman, V, Asghar, M, Ganeshram, KN, Bhowmick, BK. Chronic subdural haematoma in the elderly. Postgrad Med J 2002;78:71–5.CrossRefGoogle ScholarPubMed
Flanagan, SR, Hibbard, MR, Riordan, B, et al. Traumatic brain injury in the elderly: diagnostic and treatment challenges. Clin Geriatr Med 2006;22:449–68.CrossRefGoogle ScholarPubMed
Luerrsen, TG, Klauber, MR, Marshall, LF. Outcome from head injury related to patient's age: a longitudinal prospective study of adult and pediatric head injury. J Neurosurg 1988;68:409–16.CrossRefGoogle Scholar
Haydel, MJ, Preston, CA, Mills, TJ, Luber, S, Blaudeau, E, DeBlieux, PM. Indications for computed tomography in patients with minor head injury. N Engl J Med 2000;343:100–5.CrossRefGoogle ScholarPubMed
Stiell, IG, Wells, GA, Vandemheen, K, Clement, C, Lesiuk, H, Laupacis, A, et al. The Canadian CT Head Rule for patients with minor head injury. Lancet 2001;357:1391–6.CrossRefGoogle ScholarPubMed
Karni, A, Holtzman, R, Bass, T, Zorman, G, Carter, L, Rodriguez, L, et al. Traumatic head injury in the anticoagulated elderly patient: a lethal combination. Am Surg 2001;67:1098–100.Google ScholarPubMed
Lavoie, A, Ratte, S, Clas, D, Demers, J, Moore, L, Martin, M, et al. Preinjury warfarin use among elderly patients with closed head injuries in a trauma center. J Trauma 2004;56:802–7.CrossRefGoogle Scholar
Reynolds, FD, Dietz, PA, Higgins, D, Whitaker, TS. Time to deterioration of the elderly, anticoagulated, minor head injury patient who presents without evidence of neurologic abnormality. J Trauma 2003;54:492–6.CrossRefGoogle ScholarPubMed
The State of Aging and Health in America 2007. Atlanta, Georgia: Centers for Disease Control and Prevention, National Center for Injury Control and Prevention; 2007.
Rubenstein, LZ. Falls in older people: epidemiology, risk factors and strategies for prevention. Age Ageing 2006;35-S2:ii37–ii41.CrossRefGoogle ScholarPubMed
Thurman, DJ, Stevens, JA, Rao, JK. Practice parameter: assessing patients in a neurology practice for risk of falls (an evidence-based review). Neurology 2008;70:473–9.CrossRefGoogle Scholar
McGwin, G, Sims, RV, Pulley, L, Roseman, JM. Relations among chronic medical conditions, medications, and automobile crashes in the elderly: A population-based case-control study. Am J Epidemiol 2000;152:424–31.CrossRefGoogle ScholarPubMed
Goldstein, FC, Levin, HS, Presley, RM, Searcy, J, Colohan, ART, Eisenberg, HM, et al. Neurobehavioural consequences of closed head injury in older adults. J Neurol Neurosurg Psychiatry 1994;57:961–6.CrossRefGoogle ScholarPubMed
Blessed, G, Tomlinson, BE, Roth, M. The association between quantitative measures of dementia and of senile change in the cerebral grey matter of elderly subjects. Br J Psychiatry 1968;114:797–811.CrossRefGoogle ScholarPubMed
,Army Individual Test Battery. Manual of Directions and Scoring. Washington DC: War Department, Adjutant General's Office; 1944.Google Scholar
Wechsler, D. Wechsler Memory Scale-Revised. New York: Psychological Corporation; 1987.Google Scholar
Hannay, HJ, Levin, HSThe Continuous Recognition Memory Test. Houston: Neuropsychological Resources; 1988.Google Scholar
Libon, DJ, Mattson, RE, Glosser, G, Kaplan, E, Malamut, BL, Sands, LP, et al. A nine-word dementia version of the California Verbal Learning Test. Clin Neuropsychol 1996;10:237–44.CrossRefGoogle Scholar
Benton, AL, Hamsher, KdeS. Multilingual Aphasia Examination. Iowa City: University of Iowa; 1976.Google Scholar
Nelson, HE.A modified card sorting test sensitive to frontal lobe deficits. Cortex 1976;12:313–24.CrossRefGoogle Scholar
Wechsler, D. Wechsler Adult Intelligence Scale-Revised. New York: Psychological Corporation; 1981.Google Scholar
Aharon-Peretz, J, Kliot, D, Amyel-Zvi, E, Tomer, R, Rakier, A, Feinsod, M. Neurobehavioural consequences of closed head injury in the elderly. Br Inj 1997;11:871–5.CrossRefGoogle ScholarPubMed
Luukinen, H, Viramo, P, Koski, K, Laippala, P, Kivela, S-L.Head injuries and cognitive decline among older adults: a population-based study. Neurology 1999;52:557–62.CrossRefGoogle ScholarPubMed
Folstein, MF, Folstein, SE, McHugh, PR. Mini-mental state: A practical method for grading the cognitive state of patients for the physician. J Psychiatric Res 1975;12:189–98.CrossRefGoogle Scholar
Rapoport, MJ, Herrmann, N, Shammi, P, Kiss, A, Phillips, A, Feinstein, A.Outcome after traumatic brain injury sustained in older adulthood: a one-year longitudinal study. Am J Geriatr Psychiatry 2006;14:456–65.CrossRefGoogle ScholarPubMed
Rapoport, M, Wolf, U, Hermann, N, Kiss, A, Shammi, P, Reis, M, et al. Traumatic brain injury, apolipoprotein E-e4, and cognition in older adults: a two-year longitudinal study. J Neuropsychiatry Clin Neurosci 2008;20:68–73.CrossRefGoogle Scholar
Mazzucchi, A, Cattelani, R, Missale, G, Gugliotta, M, Brianti, R, Parma, M. Head-injured subjects aged over 50 years: correlations between variables of trauma and neuropsychological follow-up. J Neurol 1992;239:256–60.Google ScholarPubMed
Goldstein, FC, Levin, HS, Goldman, WP, Clark, AN, Kenehan-Altonen, T.Cognitive and neurobehavioral functioning after mild and moderate traumatic brain injury. J Int Neuropsych Soc 2001;7:373–83.CrossRefGoogle Scholar
Goldstein, FC, Levin, HS. Cognitive outcome after mild and moderate traumatic brain injury in older adults. J Clin Exp Neuropsychol 2001;23:739–53.CrossRefGoogle ScholarPubMed
Levin, HS, O'Donnell, VM, Grossman, RG. The Galveston Orientation and Amnesia Test: a practical scale to assess cognition after head injury. J Nerv Mental Dis 1979;167:675–84.CrossRefGoogle ScholarPubMed
Goldstein, FC, Levin, HS, Roberts, VJ, Goldman, WP, Kalechstein, AS, Winslow, M, Goldstein, SJ. Neuropsychological effects of closed head injury in older adults: a comparison with Alzheimer's Disease. Neuropsychology 1996;10:147–54.CrossRefGoogle Scholar
Breed, S, Sacks, A, Ashman, TA, Gordon, WA, Dahlman, K, Spielman, L.Cognitive functioning among individuals with traumatic brain injury, Alzheimer's disease, and no cognitive impairments. J Head Trauma Rehabil 2008;23:149–57.CrossRefGoogle ScholarPubMed
Levin, HS, Goldstein, FC, MacKenzie, EJ.Depression as a secondary condition following mild and moderate traumatic brain injury. Sem Clin Neuropsychiatry 1997;2:207–15.Google ScholarPubMed
Goldstein, FC, Levin, HS, Goldman, WP, Kalechstein, AD, Clark, AN, Kenehan-Altonen, T. Cognitive and behavioral sequelae of closed head injury in older adults according to their significant others. J Neuropsychiatry Clin Neurosci 1999;11:38–44.CrossRefGoogle ScholarPubMed
Schwartz, GE. Development and validation of the Geriatric Evaluation by Relative's Rating Instrument (GERRI). Psychol Rep 1983;53:479–88.CrossRefGoogle Scholar
First, MB, Gibbon, M, Spitzer, RL, Williams, JBW, Benjamin, LS. User's Guide for the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II). Washington, DC: Am Psychiatric Press; 1997.Google Scholar
Hybels, CF, Blazer, DG. Epidemiology of late-life mental disorders. Clin Geriatr Med 2003;19:663–96.CrossRefGoogle ScholarPubMed
Lawes, D. A retrospective review of emergency admission for head injury in the over 75s. Injury 2002;33:349–51.CrossRefGoogle ScholarPubMed
Dikmen, S, Machamer, J, Temkin, N.Mild head injury: facts and artifacts. J Clin Exp Neuropsychol 2001;23:729–38.CrossRefGoogle ScholarPubMed
Levin, HS, Mattis, S, Ruff, RM, Eisenberg, HM, Marshall, LF, Tabaddor, K, et al. Neurobehavioral outcome following minor head injury: a three center study. J Neurosurg 1987;66:234–43.CrossRefGoogle ScholarPubMed
Ponsford, J, Willmott, C, Rothwell, A, Cameron, P, Kelly, AM, Nelms, R.Factors influencing outcome following mild traumatic brain injury in adults. J Int Neuropsych Soc 2000;6:568–79.CrossRefGoogle ScholarPubMed
Williams, DH, Levin, HS, Eisenberg, HM.Mild head injury classification. Neurosurgery 1990;27:422–8.CrossRefGoogle ScholarPubMed
Rapoport, MJ, Kiss, A, Feinstein, A. The impact of major depression on outcome following mild-to-moderate traumatic brain injury in older adults. J Affect Disord 2006;92:273–6.CrossRefGoogle ScholarPubMed
Cifu, DX, Kreutzer, JS, Marwitz, JH, Rosenthal, M, Englander, J, High, W. Functional outcomes of older adults with traumatic brain injury: a prospective, multicenter analysis. Arch Phys Med Rehabil 1996;77:883–8.CrossRefGoogle ScholarPubMed
Frankel, JE, Marwitz, JH, Cifu, DX, Kreutzer, JS, Englander, J, Rosenthal, M. A follow-up study of older adults with traumatic brain injury: taking into account decreasing length of stay. Arch Phys Med Rehabil 2006;87:57–62.CrossRefGoogle ScholarPubMed

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