Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-5cf477f64f-2wr7h Total loading time: 0 Render date: 2025-04-05T22:33:17.714Z Has data issue: false hasContentIssue false

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
Get access

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

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

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

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×