Traumatic Brain Injury (TBI) and Elderly
Falls are the leading cause of TBI-related hospitalizations for older adults.
In California, during 2005, a total of 66,986 hospitalizations from falls were reported among people 65 years and older.
In California, fall-related TBI’s have a substantial impact on the health-care delivery system. Among those 85 years and older, three out of five hospitalizations resulted in a discharge to a residential facility with skilled nursing or to an in-home health service with outpatient rehabilitation services. Among older persons, an estimated annual average of 3,000 nonfatal falls results in hospitalizations for TBI at an estimated cost of $50 million.
Older persons are at increased risk for fall-related TBI hospitalizations for at least three reasons:
- Older persons are more likely to have chronic diseases and to use more medications whose adverse effects can lead to falls. Certain medications might cause dizziness, drowsiness, and postural hypotension.
- Even without medication effects, older adults might have impaired balance, slower reaction times, and decreased muscle strength, all of which can lead to more frequent falls.
- Older adults who fall often sustain more severe head injuries than their younger counterparts. Falls are a major cause of intracranial lesion among older persons because of their greater susceptibility to acute subdural hematoma.
References
- Centers for Disease Control and Prevention: Public Health and Aging: Nonfatal Fall-Related Traumatic Brain Injury Among Older Adults --- California, 1996—1999
- California Department of Health Services: Injuries in California. Available at www.apps.cdph.ca.gov/epicdata
- Average charges, (including all inpatient charges except physician fees) for falls resulting in hospitalization in California in 1999 are $17,086 per occurrence
- Tinetti ME. Preventing falls in elderly persons: N Engl J Med 2003; 348:42-9
