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Traumatic Brain Injury in Older Adults: Support & Advice



  • When a patient visits the emergency room with a case of suspected TBI, the doctor will first seek to assess the extent of the injury.
  • Traumatic Brain Injury (TBI) is a disturbance of normal operations of the brain caused by a blow, bump, or violent shaking of the head.
  • When there is a sudden blow to the head or violent shaking, a person can experience “mass lesions” in the brain and other complications.

Traumatic Brain Injury (TBI) is a disturbance of normal operations of the brain caused by a blow, bump, or violent shaking of the head. It also happens when the head abruptly hits an object or when an object hits or penetrates through the skull and damages brain tissue.

There are two major types of TBI: Open TBI refers to situations where the skull breaks, and closed TBI, the skull remains intact. TBI can also be classified according to severity. It can be mild, moderate, or severe.

Among older adults (65 years and older), TBI is a major problem. The CDC termed it the silent epidemic among a silent population in a report to Congress. Research shows that it is responsible for more than 80,000 visits to the emergency room each year. Senior adults (aged 75 and above) have the highest rate of hospitalization and death due to TBI.

This article explains the causes and treatment of TBI in older adults, plus gives support and advice.

Causes of TBI

As we mentioned in the opener, a blow to the head, jolting, or piercing by an object can cause Traumatic Brain Injury. Some of the events that may lead to TBI among older adults include the following:

Falls are by far the leading cause of TBI among older adults. They account for more than half (51%) of all cases. Older adults often fall from the bed or when going up or down the stairs. Sometimes they fall in the bath or from a ladder. These falls can cause mild or moderate TBI.

Vehicle-related collisions are the second-most-common event resulting in TBI among older adults. They account for nearly one in ten (9%) of all cases and include car, motorcycle, or bicycle collisions. Also under this group are cases of pedestrians involved in vehicle accidents.

Assault stories among older adults are not often in the news. But they still make up 1% of TBI cases among older adults in America. Common causes are gunshot wounds, domestic violence, and other assaults. There are also reports of TBI caused by violent shaking as a form of elder abuse.

Sports such as boxing, soccer, football, baseball, hockey, wrestling, and other high-impact pastime or extreme recreation activities often lead to TBI. But these are more prevalent among younger adults and youth.

Combat activities and explosive blasts can also result in Traumatic Brain Injury. But these causes are not common among older adults. Flying debris or falling objects can hit the head and injure the brain.

Types of Injuries

When there is a sudden blow to the head or violent shaking, a person can experience “mass lesions” in the brain and other complications. There are different types of complications that may arise due to TBI. They include the following:

  • Hematoma: a blood clot within the brain.
  • Contusion: bruising of brain tissue.
  • Intracerebral Hemorrhage (ICH): bleeding within the brain tissue.
  • Subarachnoid Hemorrhage (SAH): bleeding into the subarachnoid space.
  • Diffuse Injuries. These are microscopic changes to the brain that do not appear on CT scans and are scattered throughout the brain.
  • Diffuse Axonal Injury: Disruption of axon function and the gradual loss of axons.
  • Ischemia: Insufficient blood supply to certain parts of the brain.

Depending on the type of injury, a doctor would prescribe surgical treatment, pharmaceutical treatment, or a combination. In most instances, patients also go through physical therapy to restore lost or impaired brain functions. Below are some of the treatments available for TBI.

Treatment and Recovery

Older adults often ignore symptoms of mild TBI and go without treatment. It is not a surprise to hear one say, “I’m just a little shaken, but I’ll be alright after I rest.” However, even mild TBI, especially when it is regular, could result in degenerative brain disorders. It can also be fatal. One should avoid further exposure until after receiving a nod from a doctor. The doctor can prescribe either surgical treatment or medications, or a combination of the two, and follow-up physical therapy for recovery.


When a patient visits the emergency room with a case of suspected TBI, the doctor will first seek to assess the extent of the injury. They will then stabilize him/her and prevent further brain damage. To achieve this and control symptoms, the doctor could administer drugs to sedate the patient or give pain relievers, diuretics, or anti-seizure medication. If the patient requires less oxygen in the brain, doctors can administer coma-inducing medication.


In some cases, surgery may be necessary to remove hematoma, repair skull fracture, or create an opening in the skull to relieve pressure on the brain.


Due to the nature of Traumatic Brain Injury, patients often require prolonged treatment and therapy for recovery. The first step in successful recovery from TBI is to avoid exposure to high-risk behavior, occupations, and environments. Avoid activities or events that are likely to cause another blow or jolt to the head. Even if the activities are part of your norm, avoid them. Also, avoid other risky activities like driving or cycling.

Second, follow the doctor’s instructions. Mild and moderate Traumatic Brain Injury is a silent epidemic because the effect of the injury is often not immediate or apparent. It is easy to ignore symptoms and doctor’s instructions. But the long-term effects could be fatal.

Finally, take proactive measures to aid in brain recovery like sleeping for sufficient hours, avoiding retrogressive habits, and engaging in gentle exercise. Studies suggest that the risk of certain mental illnesses, such as depression, increase when someone experiences TBI, so be sure to address any mental health concerns with your doctor, and consider seeing a mental health professional. Don’t hesitate to take care of your mental health while your brain’s physical health is recovering, as the two are strongly connected.

A final word on TBI

Traumatic Brain Injury can be fatal, avoid the causes and take measures to protect yourself. If you have experienced any blow to the head or a jolt, consult a doctor and seek treatment. Remember to follow the doctor’s instructions even when the injury is not apparent.

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