Brain Injury Among Older Adults

What you’ll find on this page:

• Why brain injuries may be missed or misdiagnosed among older adults.
• The importance of getting care for an older adult after a brain injury.
• Information on stroke and traumatic brain injury among older adults.

Brain injuries may be missed among older adults

Many people, including older adults with a brain injury, have a good recovery.^1,2 This is especially true when the treatment and care provided is specialized for their age and needs.² However, older adults may be less likely to receive rehabilitation and other medical care due to the misconception that they often have poor health outcomes after a brain injury or may not be able to rehabilitate well.³ Brain injuries may also be missed or misdiagnosed among older adults because symptoms of brain injury may be similar to those of other medical conditions, like dementia and vertigo.^1,2

Stroke risk increases with age

Strokes can and do occur at any age, but older adults have a higher risk of stroke. High blood pressure, high cholesterol, smoking, obesity, and diabetes are leading causes of stroke. Stroke is serious, but recovery among older adults is possible. Getting care quickly, following a treatment plan, and getting rehabilitation services can help people regain independence and improve their quality of life.

Learn more about stroke and watch videos from our BIAA Stroke Symposium.

Falls are the leading cause of TBIs among older adults⁴

Medical professionals should do a fall risk assessment and check for signs and symptoms of a TBI if a person has hit their head, including after a fall.^5,6 This is especially important if a person has a bleeding disorder or is taking blood thinners, such as:

• Anticoagulants such as warfarin (Coumadin), rivaroxaban (Xarelto), and apixaban (Eliquis).
• Antiplatelet medications such as clopidogrel (Plavix), ticagrelor (Brilinta), and acetylsalicylic acid (Aspirin).

These medicines may increase the risk for bleeding in the brain following a concussion or other TBI.^5,6 Bleeding in the brain may put a person at risk for more severe injury or death.

References

1. National Academies of Sciences, Engineering, Medicine, Health, et al. The National Academies Collection: Reports funded by National Institutes of Health. In: Bowman K, Matney C, Haag T, Nicholson A, eds. Approaches to Address Unmet Research Needs in Traumatic Brain Injury Among Older Adults: Proceedings of a Workshop. National Academies Press (US) Copyright 2025 by the National Academy of Sciences. All rights reserved.; 2025.

2. Living AfC. Aging Guide: Considerations and Best Practices for Older Adults with Brain Injury. 2024.

3. Barrett JW, Williams J, Griggs J, Skene S, Lyon R. What are the demographic and clinical differences between those older adults with traumatic brain injury who receive a neurosurgical intervention to those that do not? A systematic literature review with narrative synthesis. Brain Inj. Jun 7 2022;36(7):841–849. doi:10.1080/02699052.2022.2093398

4. Centers for Disease Control and Prevention. Surveillance Report of Traumatic Brain Injury-related Deaths by Age Group, Sex, and Mechanism of Injury—United States, 2018 and 2019. 2022. https://www.cdc.gov/traumaticbraininjury/pdf/TBI-surveillance-report-2018-2019-508.pdf

5. Valente JH, Anderson JD, Paolo WF, et al. Clinical Policy: Critical Issues in the Management of Adult Patients Presenting to the Emergency Department With Mild Traumatic Brain Injury: Approved by ACEP Board of Directors, February 1, 2023 Clinical Policy Endorsed by the Emergency Nurses Association (April 5, 2023). Ann Emerg Med. May 2023;81(5):e63–e105. doi:10.1016/j.annemergmed.2023.01.014

6. Maegele M, Schöchl H, Menovsky T, et al. Coagulopathy and haemorrhagic progression in traumatic brain injury: advances in mechanisms, diagnosis, and management. The Lancet Neurology. Aug 2017;16(8):630–647. doi:10.1016/s1474-4422(17)30197-7

Compassionate answers. Real support. Every step of the way.

Contact the National Brain Injury Information Center at 1-800-444-6443 or braininjuryinfo@biausa.org to speak to a specialist about:

• Help with care needs
• Legal and financial resources
• Services in your community