ABSTRACT
Traumatic brain injury (TBI) is a significant public health problem that increasingly affects older adults. The causes, clinical manifestations, and short- and long-term outcomes of TBI in older adults are largely different from those seen in younger TBI survivors, requiring clinicians to have specialized knowledge of TBI in this population. Older adults with a remote or recent history of TBI are at increased risk for adverse cognitive outcomes, including transition to mild cognitive impairment or dementia. Common health-related risk factors, demographic factors and medical comorbidities in the elderly heighten the likelihood of poor outcomes, and older adults are more prone to TBI-related complications such as subarachnoid or subdural bleeds. Cognitive reserve may buffer the transition to pathological aging in the older adult but may itself be compromised in more severe injuries. In a subset of older adults exposed to repetitive brain trauma, the risk of developing specific forms of brain pathology (e.g., CTE) is heightened, though the necessary and sufficient conditions for such outcomes are as yet unclear. Neuropsychologists who work in geriatric settings should have working knowledge of these facts and should be prepared to aggressively identify and treat risk factors that may lead to poorer post-acute or chronic outcomes in these patients.
