The risk for traumatic brain injury has always been higher than the rates for the average healthy person, and researchers are finally starting to understand why our seniors are at such a heightened risk.
A study published in the Canadian Medical Association Journal confirmed that seniors in long-term facilities are at a heightened risk of head injuries, caused by a higher risk for head impacts in falls. In the study, 37 percent of seniors suffered head impacts during falls.
Falls are the cause for the majority of hospital stays in seniors over the age of 65 years old, but it does appear the incident rate is increasing, especially in those over the age of 80.
“Recent studies have documented a rapid increase among older adults in age-adjusted rates for fall-related head injuries, especially in the long-term care environment,” writes Stephen Robinovitch, Simon Fraser University, Vancouver, BC, with coauthors. “The reasons for these trends are poorly understood.”
The researchers wanted to know why so many falls resulted in head injury, so the researchers viewed video footage of 227 falls in 133 residents of a long-term care facility. They saw that head impacts were much higher than the rate found in the normal population. Out of those who suffered head impacts, 63 percent hit their head against the ground, 13 percent hit a wall, and 16 percent struck against furniture. Even worse, most of the falls were on hard flooring such as tile or linoleum.
The risk of head impact is incredibly low in young people, but there are many factors contributing to head impacts in senior citizens. The likelihood of head impact is considerably higher with forward falls than for backward falls, but attempts to use the hands or arms to break falls were ineffective in the elderly patients.
“Although we cannot identify why hand impact was generally ineffective in halting downward movement and preventing head impact, likely causes include ineffective arm placement; nonoptimal muscle tone or muscle activation at impact; and insufficient strength in upper-limb, neck and trunk muscles, which is amenable to improvement through resistance training,” the authors write.
The authors also offered areas which could benefit from improvement. Better procedures to detect possible brain injuries from falls would provide better care and injury management, exercises to strengthen upper limbs would increase the efficacy of attempts to break falls with hands, and creating safer environments for residents (such as softer floors to cushion impacts) would decrease the severity of injuries.