Brain Damage a Risk of Falls in the Elderly

Many have referred to late in life as the Golden Years, but those "golden" years are plagued with all kinds of fears and perils for the elderly. Many older people will worry about finances, where to live, transportation, how to afford medical care, and the fear of falling is ever present on their minds. Breaking an arm, a wrist—or the worst—a hip was once the most feared outcome of an unexpected fall. Now the Centers for Disease Control and Prevention (CDC) says Traumatic Brain Injuries (TBIs) caused by a bump or blow to the head, resulted in nearly 8,000 deaths in 2005, and a significant amount of those were in the elderly.

TBIs represent 50% of all fall-related deaths of people age 65 and older and are responsible for 8% or about 56,000 nonfatal fall-related hospitalizations.The data showed that men are at a higher risk of dying from TBIs than women, but women were hospitalized slightly more often due to fall-related brain injury, with the average hospital stay being from two to six days and medical cost ranging from $16,000 to $20,000. The risk of falling increased with age for both genders due to such conditions as weakening muscles, poor balance, change or loss of vision, numbness in the limbs, overall failing health, environmental hazards, and side effects from medications. Added risk of TBIs occurred for anyone taking blood-thinning medication, as it often leads to profuse bleeding from even minor bumps.

Most symptoms of a brain injury appear immediately or shortly after a blow or bump to the head and can affect many different aspects of your physical and emotional well-being, often resulting in long-term cognitive, emotional, and/or functional impairments. In many cases, the symptoms are so subtle they are easily missed—even for the person who's been injured.

Signs and symptoms of a mild brain injury can include:

• Brief period of unconsciousness
• Headache
• Confusion
• Dizziness
• Sensory problems, such as blurred vision, ringing in the ears or a bad taste in the mouth
• Mood changes
• Memory or concentration problems

Signs and symptoms of moderate to severe brain injury include:

• Persistent headache
• Repeated vomiting or nausea
• Convulsions or seizures
• Inability to awaken from sleep
• Dilation of one or both pupils of the eyes
• Slurred speech
• Weakness or numbness in the extremities
• Loss of coordination and Increased confusion

"Most people think older adults may only break their hip when they fall, but our research shows that traumatic brain injuries can also be a serious consequence," said Dr. Ileana Arias, director of CDC's National Center for Injury Prevention and Control. "These injuries can cause long-term problems and affect how someone thinks and functions."

Just because you are aging doesn't mean that you will suffer from any TBI, or that you will fall at all, but the 2005 study reported that nearly 16,000 elderly adults died from falls, another 1.8 million were treated in emergency facilities, with 433,000 of those being admitted to the hospital. About one in every three older Americans will fall each year, making fall-related injuries the leading cause of death in people over 65 years of age. This study data was taken from the National Center for Health Statistics' National Vital Statistics System and the Agency for Healthcare Research and Quality's Nationwide Inpatient Sample and the findings were released in the June issue of the Journal of Safety Research.

The CDC recently developed the "Help Seniors Live Better, Longer: Prevent Brain Injury" initiative. Developed in collaboration with 26 organizations, it features easy-to-use English- and Spanish-language materials in a concise question-and-answer format to help prevent, recognize, and respond to TBI. For more information and materials, visit www.cdc.gov/BrainInjuryInSeniors. They have also created resources for practitioners and community-based organizations that can be downloaded or ordered at www.cdc.gov/ncipc/preventingfalls.