According to three studies appearing online in NeuroRehabilitation, there is room for improvement in existing interventions to enhance outcomes in older adults with traumatic brain injury (TBI).  

Researchers from the Icahn School of Medicine at Mount Sinai reportedly conducted the studies, the first of which suggests that compared to older adults with dementia with no history of TBI, individuals with a history if TBI exhibited higher fluency and verbal memory scores and later onset of decline. Yet, the results indicate the general health in individuals with a history of TBI was worse than their counterparts without TBI and made them more likely to have received medical attention for depression, and were more likely to have gait disorders, falls, and motor slowness. The results suggest, researchers say, that dementia among individuals with a history of TBI may demonstrate a unique clinical phenotype different from those observed among older adults who develop dementia without a history of TBI.

In the second study, researchers note they assessed the precise causes for what may be considered a premature death in older adults with TBI. The results suggest that a third of the patients, mortality one to 5 years following TBI resulted from existing health conditions present at the time of injury prior to the onset of TBI, indicating continued progress of an already ongoing condition. 

“This study suggests that close medical management and lifestyle interventions may help to prevent premature death among elderly survivors of TBI in the future,” says Wayne Gordon, PhD, Jack Nash Professor and vice chair of the department of rehabilitation medicine at the Icahn School of Medicine at Mount Sinai, chief of the rehabilitation psychology and neuropsychology service. 

The results reinforce Gordon’s point, suggesting that compared to patients who survived several years after injury, deceased patients were discharged from the hospital with significantly more medications.

In the third and final study, researchers report that they investigated the difference in treatment and outcomes in older adult patients and younger patients with TBI. Patients aged 65 years and older exhibited lower brain injury severity and shorter length of stay in acute care. Older adult patients also received fewer hours of rehabilitation therapy as a result of shorter length of stay and fewer hours of treatment per day. In effect, the patients gained less functional ability during and after rehabilitation, and demonstrated a very high mortality rate, researchers say. 

While the data indicates that older adults can be rehabilitated successfully, according to Marcel Dijikers, PhD, lead author, research professor in the department of rehabilitation medicine at Mount Sinai, “it raises a number of questions. For instance: is the high mortality rate due to the TBI or is it the result of the continuing of a condition that began pre-TBI?,” Dijikers says.

Source: The Mount Sinai Hospital/Mount Sinai School of Medicine