Preventing Traumatic Brain Injury in Older Adults

A traumatic brain injury (TBI) is caused by a bump or blow to the head that affects how the brain normally works. TBI is a special health concern for older adults. People ages 75 and older have the highest rates of TBI-related hospitalizations and death. They also recover more slowly and die more often from these injuries than do younger people. Falls are the leading cause of TBI.

What are the signs and symptoms of TBI?

A person with moderate or severe TBI may show these symptoms:

• If you experience even mild symptoms of TBI after a bump or blow to the head, contact your healthcare provider right away.

  A headache that gets worse or does not go away
• Repeated vomiting or nausea
• Convulsions or seizures
• Inability to wake up from sleep
• Dilation of one or both pupils
• Slurred speech
• Weakness or numbness in the arms or legs
• Loss of coordination
• Increased confusion, restlessness, or agitation

Symptoms that may indicate mild TBI include:

• Low-grade headache that won’t go away
• Having more trouble than usual remembering things, paying attention or concentrating, organizing daily tasks, or making decisions and solving problems
• Slowness in thinking, speaking, acting, or reading
• Getting lost or easily confused
• Feeling tired all of the time, lack of energy or motivationouble sleeping
• Loss of balance, feeling light-headed or dizzy
• Increased sensitivity to sounds, lights, distractions
• Blurred vision or eyes that tire easily
• Loss of sense of taste or smell
• Ringing in the ears
• Mood changes like feeling sad, anxious, or listless, or becoming easily irritated or angry for little or no reason

Older adults taking blood thinners (e.g. Coumadin) should be seen immediately by a health care provider if they have a bump or blow to the head, even if they do not have any of the symptoms listed above.

If TBI is suspected, call the doctor immediately. Tell the doctor if the person is taking any prescription drugs, including over-the-counter medicines, blood thinners, or aspirin.

Can Traumatic Brain Injury be prevented?

Yes. The most effective way to prevent TBI is to protect against falls, the most common cause of TBI among older adults. Fall prevention includes…

• Increasing exercise. Exercises that improve balance and coordination, like Tai Chi, are most helpful. Check with your healthcare provider about which exercises are safest and best.
  
  
• Making the home or surroundings safer. Remove things from stairs and floors; add brighter lighting; remove small throw rugs; install handrails and grab bars in the bathroom; place non-stick mats in the bathtub and on shower floors.
  
  
• Asking your health care provider to review all medicines. This includes all prescription medicines, as well as non-prescription drugs like cold medicines and supplements. As people age, the way some medicines work in the body can change. This could cause a person to feel drowsy or lightheaded, which could lead to a fall.
  
  
• Having your vision checked. Your eye doctor can check to be sure eyeglasses are correct and that there are no conditions that limit vision, like glaucoma or cataracts. Poor vision can increase the chance of falling.

“Help Seniors Live Better, Longer: Prevent Brain Injury” is a CDC initiative to raise awareness among children and other caregivers of older adults about ways to prevent, recognize, and respond to TBI in adults 75 and older. Call the Centers for Disease Control and Prevention (CDC) toll-free at 1-800-CDC-INFO (1-800-232-4636) or visit www.cdc.gov/BrainInjuryInSeniors for more resources and information.

For more fall protection resources and information, see Issue 5: Preventing Falls in your Aging in Stride Reader Support Center.

Also see “10 Myths and Facts About Falls” in the August 2006 issue of the Aging in Stride Bi-Monthly.