Preventing Brain Injury in Older Adults

March 16-22 is Brain Awareness Week. When we think about things that cause cognitive problems for older adults, most of us focus on Alzheimer's disease or stroke. But a sudden change in mental condition of a senior loved one might be the result of a traumatic brain injury.

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.

What are the signs and symptoms of TBI?

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
• 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.

A person with moderate or severe TBI may also have the symptoms above, and may also have:

• A headache that gets worse or does not go away
• 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
• Confusion, restlessness, or agitation.

What should I do if I think an older loved one has a TBI?

If TBI is suspected, call the doctor immediately. Tell the doctor if your loved one is taking any prescription drugs, including over-the-counter medicines, blood thinners, or aspirin. Older adults who do take blood thinners (for example, Coumadin) should be seen immediately by a health care provider if they experience a bump or blow to the head, even if they do not have any of the symptoms listed above.

Can TBI 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. Ask the healthcare provider for a recommendation.

Making the home or surroundings safer. Remove stray items 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.

Having the health care provider 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 vision checked. Your love one's 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.

For More Information

To learn more about Brain Awareness Week, visit the website of Neuroscience Canada.

Falls are the top cause of traumatic brain injury in seniors. Learn more about protecting seniors against falls in the January 2009 issue of Choices.