Falls and TBI
Falls and TBI
Kelli Barton, PhD
Gerontologist
Director, Heath and Aging
January 10,2023
Show Me Falls Free Missouri Coalition
Agenda
•
What is TBI?
•
Falls, TBI, and Aging
•
Resources
What is a Traumatic Brain Injury (TBI)?
•
A head injury caused by a bump, blow, or jolt
to the head or body or a penetrating head
injury that results in disruption of normal brain
function (CDC)
•
A major cause of death and disability
•
Symptoms can range widely
•
Depending on the severity of the injury, those
who get a TBI may face health problems that
last a few days or the rest of their lives
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https://www.cdc.gov/traumaticbraininjury/index.html
Mild TBI & Concussion Symptoms
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May appear right away or may not appear for hours
or days after injury
•
Typically improve over time, and most people with a
mild TBI or concussion feel better within weeks
P
h
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s
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c
a
l
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Bothered by light or noise
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Dizziness or balance problems
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Feeling tired, no energy
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Headaches
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Nausea or vomiting (early on)
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Vision problems
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Attention or concentration problems
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Feeling slowed down
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Foggy or groggy
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Problems with short- or long-term
memory
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Trouble thinking clearly
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m
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Anxiety or nervousness
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Irritability or easily angered
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Feeling more emotional
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Sadness
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p
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Sleeping less than usual
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Sleeping more than usual
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Trouble falling asleep
https://www.cdc.gov/traumaticbraininjury/concussion/symptoms.html
Nearly
30%
of
adults report having
had a concussion in
their lifetime.
Source:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7048626/
According to one
survey,
42%
of
respondents with a
TBI did not seek
medical care.
Source:
https://www.tandfonline.com/doi/abs/10.1080/02699050601111419
Moderate & Severe TBI
•
May result in an extended period of unconsciousness
(coma) or amnesia
•
Can lead to long-term or life-long health problems that may
affect all aspects of a person’s life
•
Effects may change over time
https://www.cdc.gov/traumaticbraininjury/concussion/symptoms.html
T
h
i
n
k
i
n
g
a
n
d
L
e
a
r
n
i
n
g
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Difficulty understanding and
thinking clearly
•
Trouble communicating and
learning skills
•
Problems concentrating
•
Difficulty remembering
information
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o
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r
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n
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V
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s
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o
n
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Weakness in arms and legs
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Problems with coordination and
balance
•
Problems with hearing and vision
•
Changes in sensory perception,
such as touch
E
m
o
t
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o
n
/
M
o
o
d
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Feeling more emotional
than usual
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Nervousness or anxiety
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Feeling more angry or
aggressive than usual
•
Sadness, depression
B
e
h
a
v
i
o
r
•
Trouble
controlling
behavior
•
Personality
changes
•
More impulsive
than usual
Falls, TBI, and Aging
•
Falls are the most common cause of TBI,
particularly in older adults and young children
•
TBIs often missed or misdiagnosed in older
adults because symptoms overlap with other
medical conditions that are common among
older adults, such as dementia
•
Older adults are more likely to be hospitalized
and die from a TBI than other age groups
Falls are the most common
cause of TBI hospitalizations.
Source: CDC, 2017 Estimates
Source:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7367089/
•
National rate of fall-related TBI deaths
increased by 17% from 2008 to 2017
•
Rates increased significantly in 29 states
(including Missouri)
•
In 2017, national rates were highest
among persons age 75+ and males
•
The rate among persons age 75+ was
about 8x higher than that among
those aged 55–74 years
Deaths from Fall-
Related TBI, 2008-2017
Fall/Jump-Related TBI in MO by Age
Source: MO DHSS 2015 MICA data
Frailty
•
Related to increased risk
of falls
•
Not a direct natural
consequence of aging
•
Often results from
intersection of age-related
decline with chronic
diseases and conditions
•
Ground or low-level (low-
energy) falls, which are
typical in frail patients, is
the major cause for the
increasing prevalence of
elderly patients with TBI
Source:
https://journals.lww.com/co-criticalcare/Fulltext/2022/04000/Acute_traumatic_brain_injury_in_frail_patients_.10.aspx
•
Healthcare providers should
check for signs and symptoms of
TBI if an older adult has:
•
Fallen or has a fall-related injury,
such as a hip fracture
•
Been in a car crash
•
This is especially important
among older adults who are
taking blood thinners
Source:
https://www.cdc.gov/traumaticbraininjury/get_the_facts.html
Resources
P
r
e
v
e
n
t
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o
n
•
Area Agencies on Aging (AAAs) disease prevention /
health promotion programs:
https://health.mo.gov/seniors/aaa/exercise-health.php
•
E.g. Matter of Balance, Tai Chi
•
Free to anyone age 60+
•
A CDC Compendium of Effective Fall Interventions:
What Works for Community-Dwelling Older Adults:
https://www.cdc.gov/homeandrecreationalsafety/pdf/fall
s/cdc_falls_compendium-2015-a.pdf
T
B
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Brain Injury Association of Missouri (BIA-MO):
https://www.biamo.org/
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DHSS Adult Brain Injury Program:
https://health.mo.gov/living/healthcondiseases/tbi/
MO Brain Injury Advisory Council (MBIAC)
•
Quarterly, next meeting: 1/23/23
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Time:10:00 a.m. – 1:00 p.m.
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Cedar Conference Room-912 Wildwood Drive, Jefferson City
OR
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Join meeting
(click on meeting -
https://stateofmo.webex.com/stateofmo/j.php?MTID=m3fa44c4
42d01c29abef83d12e09920cb
)
Meeting ID: 2455 957 4078
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Call in numbers: (573)751-6351
Contact:
Kelli Barton
bartonkn@umkc.edu
Questions?
January 10, 2023 Show Me Falls Free Missouri Coalition event to learn about TBI, falls, and aging. Presented by Kelli Barton, PhD, Gerontologist, Director of Health and Aging.
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Presentation Transcript
January 10,2023 Show Me Falls Free Missouri Coalition Falls and TBI Kelli Barton, PhD Gerontologist Director, Heath and Aging
Agenda What is TBI? Falls, TBI, and Aging Resources
What is a Traumatic Brain Injury (TBI)? A head injury caused by a bump, blow, or jolt to the head or body or a penetrating head injury that results in disruption of normal brain function (CDC) A major cause of death and disability Symptoms can range widely Depending on the severity of the injury, those who get a TBI may face health problems that last a few days or the rest of their lives In 2020, there were over 64,000 TBI- related deaths in the US or about 176 TBI- related deaths every day https://www.cdc.gov/traumaticbraininjury/index.html
Mild TBI & Concussion Symptoms May appear right away or may not appear for hours or days after injury Typically improve over time, and most people with a mild TBI or concussion feel better within weeks Sleep Sleeping less than usual Sleeping more than usual Trouble falling asleep Physical Thinking & Remembering Attention or concentration problems Feeling slowed down Foggy or groggy Problems with short- or long-term memory Trouble thinking clearly Bothered by light or noise Dizziness or balance problems Feeling tired, no energy Headaches Nausea or vomiting (early on) Vision problems Social or Emotional Anxiety or nervousness Irritability or easily angered Feeling more emotional Sadness https://www.cdc.gov/traumaticbraininjury/concussion/symptoms.html
Nearly 30% adults report having had a concussion in their lifetime. 30% of According to one survey, 42% respondents with a TBI did not seek medical care. 42% of Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7048626/ Source: https://www.tandfonline.com/doi/abs/10.1080/02699050601111419
Moderate & Severe TBI Behavior Trouble controlling behavior Personality changes More impulsive than usual May result in an extended period of unconsciousness (coma) or amnesia Can lead to long-term or life-long health problems that may affect all aspects of a person s life Effects may change over time Thinking and Learning Difficulty understanding and thinking clearly Trouble communicating and learning skills Problems concentrating Difficulty remembering information Emotion/Mood Feeling more emotional than usual Nervousness or anxiety Feeling more angry or aggressive than usual Sadness, depression Motor Skills, Hearing, and Vision Weakness in arms and legs Problems with coordination and balance Problems with hearing and vision Changes in sensory perception, such as touch https://www.cdc.gov/traumaticbraininjury/concussion/symptoms.html
Falls, TBI, and Aging Falls are the most common cause of TBI, particularly in older adults and young children TBIs often missed or misdiagnosed in older adults because symptoms overlap with other medical conditions that are common among older adults, such as dementia Older adults are more likely to be hospitalized and die from a TBI than other age groups
Falls are the most common Falls are the most common cause of TBI hospitalizations. cause of TBI hospitalizations. Deaths from Fall Deaths from Fall- - Related TBI, 2008 Related TBI, 2008- -2017 2017 National rate of fall-related TBI deaths increased by 17% from 2008 to 2017 Rates increased significantly in 29 states (including Missouri) In 2017, national rates were highest among persons age 75+ and males The rate among persons age 75+ was about 8x higher than that among those aged 55 74 years Motor vehicle traffic crashes 24% Other 27% Falls 49% Source: CDC, 2017 Estimates Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7367089/
Fall/Jump-Related TBI in MO by Age Under 15 22% Age Age Under 15 15 - 24 25 - 44 45 - 64 65 and Over 2,737 Total n n 1,660 891 868 1,290 65 and Over 37% 15 - 24 12% 7,446 25 - 44 12% 45 - 64 17% Source: MO DHSS 2015 MICA data
Frailty Related to increased risk of falls Not a direct natural consequence of aging Often results from intersection of age-related decline with chronic diseases and conditions Ground or low-level (low- energy) falls, which are typical in frail patients, is the major cause for the increasing prevalence of elderly patients with TBI Source: https://journals.lww.com/co-criticalcare/Fulltext/2022/04000/Acute_traumatic_brain_injury_in_frail_patients_.10.aspx
Healthcare providers should check for signs and symptoms of TBI if an older adult has: Fallen or has a fall-related injury, such as a hip fracture Been in a car crash This is especially important among older adults who are taking blood thinners Source: https://www.cdc.gov/traumaticbraininjury/get_the_facts.html
Resources Prevention Area Agencies on Aging (AAAs) disease prevention / health promotion programs: https://health.mo.gov/seniors/aaa/exercise-health.php E.g. Matter of Balance, Tai Chi Free to anyone age 60+ A CDC Compendium of Effective Fall Interventions: What Works for Community-Dwelling Older Adults: https://www.cdc.gov/homeandrecreationalsafety/pdf/fall s/cdc_falls_compendium-2015-a.pdf TBI Brain Injury Association of Missouri (BIA-MO): https://www.biamo.org/ DHSS Adult Brain Injury Program: https://health.mo.gov/living/healthcondiseases/tbi/
MO Brain Injury Advisory Council (MBIAC) Quarterly, next meeting: 1/23/23 Time:10:00 a.m. 1:00 p.m. Place: Hybrid meeting in person or using WebEx Cedar Conference Room-912 Wildwood Drive, Jefferson City OR Join meeting (click on meeting - https://stateofmo.webex.com/stateofmo/j.php?MTID=m3fa44c4 42d01c29abef83d12e09920cb) Meeting ID: 2455 957 4078 Meeting password: MBIAC Call in numbers: (573)751-6351
Contact: Kelli Barton bartonkn@umkc.edu Questions?
