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Traumatic Brain Injury (TBI) and the 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. Resources: • 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 http://www.dhs.ca.gov/EPICenter • 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
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