Citation

Peters ME. Int. Rev. Psychiatry 2020; 32(1): 1-2.

Affiliation

Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Copyright

(Copyright © 2020, Informa - Taylor and Francis Group)

DOI

10.1080/09540261.2019.1683959

PMID

31916509

Abstract

The population distribution in the United States is changing from a broad base of younger individuals with few individuals living to older adulthood to a much more even distribution throughout the lifespan (United States Census Bureau, 2018). A similar transformation has occurred when looking at new onset traumatic brain injury (TBI). While improved car safety features have resulted in a decrease in motor vehicle accident-related TBIs, the number of older adults presenting to emergency departments (EDs) for evaluation of TBI has increased by at least 60% with a 2009–2010 estimate showing ∼20 million older adults evaluated annually for TBI (Albrecht et al., 2016). In addition to a rising number of ED visits, older adults have rising levels of hospitalisations and death following TBI. In fact, as of 2013, adults 75 years and older sustained the highest number of TBIs—exceeding that of infants (Taylor, Bell, Breiding, & Xu, 2017). These growing numbers have created a public health priority and this issue of the International Review of Psychiatry attempts to shine light on this crisis, which deserves the same advocacy and specialised focus as sports- and military-related TBI. These individuals, as well as those aging with a TBI sustained earlier in life, warrant a focussed approach to scientific study and treatment that is informed by, yet distinct from, that of TBI in disparate populations.

From pre-injury risk factors to presenting symptoms and future complications, there exists a nuanced set of geriatric-specific factors to consider in those with new onset TBI at an older age. In the era of individualised medicine, patient characteristics and clinically relevant biomarkers are used to guide care and a one-size-fits-all approach to treatment is viewed as antiquated. There is a common assumption that older adults do worse after new onset TBI. This is supported ...

Language: en