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Most older adults with prolonged concussion recovery report multiple symptoms
Concussion injury and recovery is substantially different in populations of middle-aged and older adults compared with military and athletic populations, according to research presented at the American Academy of Neurology annual meeting.
Melissa DiFabio, a PhD candidate at the University of Delaware, and colleagues described concussion profiles in middle-aged and older adults, noting that clinical management of these patients will differ from other populations.
"Most concussion studies focus on athletic and military populations whereas middle aged and older studies typically focus on moderate-to-severe traumatic brain injury," they wrote in their abstract. "Thus, there is limited information on non-sports–related concussion presenting to a family medicine concussion clinic."
DiFabio and colleagues conducted a retrospective chart review of 47 patients aged 40 years and older who presented at a concussion clinic. They noted vestibular, neurological, physical cognitive and musculoskeletal issues in each chart, as well as injury history and symptoms.
Results showed that the most common injury mechanisms were motor vehicle accidents (35.4%) and falls (37.5%). A majority of patients (52.3%) reported a history of mental illness, the most common being anxiety (34%) and depression (40.4%). The most commonly reported symptoms were sensitivity to lights (52.1%), dizziness (58.3%), difficulty with memory (60.4%), difficulty sleeping (62.5%) difficulty concentrating (66.7%) and headache (89.6%).
In addition, a majority of patients (64.6%) reported more than five symptoms. A majority of patients (88%) had received a referral, with more than half of patients (53.2%) receiving two or more.
The researchers reported a median time between injury and clinic visits of 33.5 days.
"The majority of older adults with prolonged concussion recovery reported multiple symptoms a month postinjury," DiFabio and colleagues wrote. "This population substantially differs from the younger population with most concussion resulting from falls and [motor vehicle accidents]. The rate of pre-existing mental health illness was higher than expected for an age matched population which may play a role in the prolonged recovery. The injury profiles herein differ from athletic or military populations which adds further challenges to the clinical management of concussion amongst middle aged to older adults." – by Chelsea Frajerman Pardes
Reference:
DiFabio M, et al. Concussion profile in older adults. Presented at: American Academy of Neurology Annual Meeting; April 15-21, 2016; Vancouver, British Columbia.
Disclosures: The researchers report no relevant financial disclosures.
