Geriatric Mild Traumatic Brain Injury (mTBI)

Purpose of Review Studies that focus on geriatric mild traumatic brain injury (mTBI) are limited, although these injuries occur commonly as a result of falls in the older adult population. This review aims to explore current literature in this area and summarize common practices in diagnosis and treatment of this condition. Recent Findings Older adults who sustain a fall should be evaluated for the possibility of mTBI, with reported falls forward or the presence of upper extremity fractures being associated with increased risk of trauma to the head. Efforts to determine pre-injury cognitive status may improve the ability to diagnose mTBI and possible alteration in mental status associated with the condition. Imaging and observation may be indicated to rule out an intracranial bleed acutely. Clinical outcomes after mTBI are generally positive in older adults, so an expectation for recovery should be conveyed, with a short period of rest recommended prior to gradual resumption of routine activity that avoids risk of additional injury. Those who have prolonged symptoms that do not improve with return gradual activity may benefit from referral to a rehabilitation team that can address physical, cognitive, and psychological symptoms following mTBI. Summary Diagnosis of mTBI is difficult in older adults given the challenges in determining pre-injury cognitive status and the similarity of concussive symptoms with symptoms commonly attributed to aging. Post-concussion management in older adults is not well studied, and further research is needed to evaluate the efficacy of current concussion clinical practice guidelines developed for younger populations when applied to older adults.