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Outcome following traumatic brain injury in the elderly: a critical review
1University of Toronto, Sunnybrook and Women's Health Sciences Centre, Ontario, Canada.
Background:
The elderly are at risk for traumatic brain injury (TBI), but their outcome following these injuries remains unclear.
Objective:
This paper critically reviews research done to date on cognitive and functional outcome following TBI in the elderly.
Methods:
MEDLINE and PSYCHLIT databases going back to 1965 were searched.
Results:
Studies suggest that TBI results in adverse cognitive and functional outcomes in the elderly. There is uncertainty as to whether TBI is a significant risk factor for Alzheimer's disease (AD). Methodological problems in these studies include selection bias, small samples, retrospective analyses, and, particularly, the failure to address the role of pre-morbid functioning. These problems limit the strength of the outcome studies, and may account for the equivocal findings on AD risk.
Conclusions:
It is premature to conclude from the published research to date that the elderly have a uniformly poor outcome following TBI. Directions for further research are suggested.