As the average human lifespan continues to rise, elderly people (aged 60 years and older) comprise an increasing proportion of the global population. Consequently, health conditions associated with old age are of growing interest among health care workers who seek to provide high-quality care to all patients across the lifespan.
Of particular concern is traumatic brain injury (TBI), to which elderly people are especially vulnerable due to physical fragility and poor eyesight. In addition to increased likelihood of sustaining TBI among the elderly population, older individuals also are more prone to complications and worse outcomes than young people who sustain similar injuries.
One of these complications is cerebral microbleeds, small ruptures in the brain’s blood vessels that may accumulate over time. Any person can experience a cerebral microbleed following TBI, but elderly people are at especially high risk. In fact, the prevalence of cerebral microbleeds increases by 20% to 40% after age 65, even among individuals who have not sustained TBI. Prior evidence suggests that cerebral microbleeds are associated with neurological dysfunction and cognitive decline, which may in part account for poorer outcomes in elderly people with TBI.
New Research on Cerebral Microbleeds in Elderly Patients after TBI
A research team recently reviewed four case studies of elderly patients who experienced cerebral microbleeds following TBI. They compiled these patients’ medical records and presented several key elements shared across the four cases:
- Gait Dysfunction: Cerebral microbleeds were associated with gait dysfunction, a change in a person’s normal walking pattern. Gait dysfunction increases the risk of falling, leaving elderly patients even more vulnerable to sustaining another TBI.
- Severity of Cognitive Dysfunction: There is a positive correlation between number of cerebral microbleeds and severity of cognitive dysfunction. Given that elderly people are already at increased risk of Alzheimer’s disease and other dementias, TBI-related microbleeds may further exacerbate cognitive decline.
- Changes to Brain Vasculature: Elderly people may be more likely to experience cerebral microbleeds as a result of age-related changes to brain vasculature, such as reduced elasticity of blood vessels.
Clinicians should remain aware of increased risk for cerebral microbleeds among elderly TBI patients. These individuals may require extensive cognitive and physical rehabilitation to mitigate the potential for cognitive decline and gait dysfunction. Prevention efforts should seek to improve home safety and reduce falls among the elderly.
Works Cited: Toth L, Czigler A, Horvath P, et al. Traumatic brain injury-induced cerebral microbleeds in the elderly. GeroScience. (2021).
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