Older adults among the walking wounded with incident TBI

Traumatic brain injury accompanied by symptoms serious enough to send sufferers to the ED is surprisingly common among Americans aged 65 and up. And the demographic most at risk seems to be White women who are healthy, active and of high socioeconomic status.

That’s according to a study conducted at UC-San Francisco and published in JAMA Network Open.

Following around 9,200 subjects over an 18-year period, Erica Kornblith, PhD, and colleagues found just shy of 13% of the field experienced what the researchers call “incident” TBI.

They defined this using inpatient and outpatient ICD diagnosis codes received the same day or within one day of a visit to the emergency department in which a head CT or MRI was completed.

All study subjects had earlier completed a baseline interview for the University of Michigan’s Health and Retirement Study (HRS).

The team found that race, sex and social determinants of health “may be” associated with incident TBI. However, they were unable to precisely clarify the extent to which demographics or access to care may affect who accesses treatment for TBI.

They note their tentative finding on White wealthy women contradicts conventional wisdom on incident TBI, which holds that male sex has long been considered a risk for the head injury. The new work, they remark, “suggests this may not hold for the older adult population.”

Kornblith and co-authors state their findings are important from a public health perspective because TBI “increases risk of multiple negative outcomes associated with aging, including multisystem (neurologic, cardiovascular, and endocrine) medical comorbidity, loss of functional independence and reduced quality of life.”

Further research is likely needed to refine the weight of patient demographics and/or care access in determining susceptibility of older Americans to TBI, the authors state.

In addition, the team comments, older adults who experience falls make up the largest segment of U.S. citizens experiencing incident TBI—and the least likely to seek care. More:

‘Lower-resourced individuals may be even less likely to seek care due to multiple factors. Thus, our estimates of TBI incidence among U.S. older adults are likely to be lower than the true burden of TBI in this population and may not reflect true differential incidence of TBI based on race and ethnicity and other demographics.’

The study is available in full for free.