Older adults with prior head injury nearly twice as likely to sustain future fall

Key takeaways:

• Researchers examined more than 13,000 older adults with and without prior head injury.
• Those who suffered a prior head injury were almost two times as likely to suffer a subsequent fall.

PHILADELPHIA — Older adults who sustained a prior head injury were nearly two times as likely to sustain a future fall compared with those who did not have a prior head injury, according to a poster presentation.

“We wanted to look at the relationship between head injury and future fall risk,” Katherine J. Hunzinger, PhD, CEP, an assistant professor of exercise science at Thomas Jefferson University, told Healio at the American Neurological Association annual meeting. “Falls and head injury are most common in older adults.”

Hunzinger and colleagues sought to examine associations between sustaining head injuries and subsequent falls that required hospital care within community-dwelling older adults.

From an initial pool of 15,792 individuals, their final analysis included 13,081 older adults (mean age 54.3 years; 42.3% female, 27.9% Black) from the Atherosclerosis Risk in Communities study, a longitudinal undertaking that tracked head injury hospitalizations from 1987 to 2019. Among eligible participants, 11,293 sustained no head injury while 1,788 sustained a head injury. Participants were tracked periodically during the study interval, with a total of seven visits (1987 to 1988; 1990 to 1992; 1993 to 1995; 1996 to 1998; 2011 2013; 2016 2017 and 2018 to 2019) with a scheduled brain MRI taken between 2004 and 2006. Cox proportional hazards regression was employed to analyze associations between head injury and falls, with secondary analysis examining relationship between number of head injuries and severity with subsequent falls and adjusted for age, sex, race and education. Fine-Gray proportional hazard models were utilized in a concurrent model examining the same and adjusted for variables such as veteran status, smoking or alcohol consumption, diabetes or hypertension.

Results showed that head injuries sustained by older adults were associated with an approximate 1.7-fold increased risk for future falls compared with those who did not have a previous head injury. Stronger associations were observed for men with head injury and subsequent falls, as well as a dose-response relationship with the number and severity of the head injury.

“We found that individuals who had a [traumatic brain injury] were at risk for a subsequent fall about 6 years after that initial head injury,” Hunzinger told Healio. “And they were at almost a two times increased risk of having that fall compared to those who didn’t have a head injury.”