Concussions in the Elderly

Concussions in the Elderly

Most people know about concussions in athletes, active children and young adults. But concussions aren’t limited by age or physical activity. Increasingly, older adults are being diagnosed with concussions and other brain injuries — typically due to falls.

Often, those head injuries are overlooked in the elderly, says Alicia Puskar, PsyD, a clinical neuropsychologist with the UPMC Sports Medicine Concussion Program. The medical community is only beginning to recognize the frequency of concussions in older adults.

“Older adults who fall and land on their knees or their backside will think they can’t possibly have a concussion. But there is often enough force involved to shake the brain and cause an injury,” says Dr. Puskar.

“Whiplash from a car accident, hitting one’s head on a cabinet door, or even an innocent head butt from a young grandchild also can result in a concussion.”

Need for Treatment

Getting the right treatment is key to recovery and preventing further injury and decline in function, says Dr. Puskar. “But too often, important concussion symptoms such as dizziness, balance issues, memory problems, and anxiety, are missed because they’re incorrectly considered part of other concerns, including dementia, depression, or ‘normal aging’ in older adults.”

Without proper care, those concussion symptoms may cause older adults — even those who with active, vibrant lifestyles — to “hide away,” which can lead to isolation and a sharp decrease in social and physical activity.

“Quality of life in the elderly can decline without proper treatment of a concussion. Their world becomes smaller and they become frail, which can create more problems,” Dr. Puskar says.

Return to Normalcy

The goal of concussion treatment for an older adult is similar to that of a young athlete — to return the patient to the activity level they had prior to their injury.

“Whether that elderly patient has been an active volunteer working three or four days a week, or a homebody who enjoys gardening, our goal is to gradually return them to their normal routine as their brain recovers,” says Dr. Puskar.

Elderly patients receive the same level of high quality, skilled and multidimensional care as elite athletes in the Sports Concussion Program, she adds. Treatment plans are tailored to each person’s unique needs and concussion symptoms. For example, vestibular therapy helps with balance issues, motion sensitivity, dizziness, and difficulty reading, while cognitive rehabilitation addresses memory and concentration problems. “We often partner with the with the department of physical medicine and rehabilitation when medications are needed to address symptoms or to medically manage a physical injury,” says Dr. Puskar. “Physical therapies are tailored to help older adults rebuild their physical confidence, fitness, and stamina.”

Concussion Symptoms in the Elderly

Concussion symptoms are not always obvious, says Dr. Puskar. Some older adults might experience dizziness when they go to the grocery store or shopping mall where it’s active and noisy. Others may feel foggy, or extremely tired and run down.

Common symptoms include:
• Headache
• Dizziness
• Nausea
• Balance problems
• Fogginess, or difficulty concentrating
• Memory problems
• Sensitivity to light or noise
• Mood swings
• Anxiety
• Depression
• Sleep problems

Older adults experiencing such symptoms should talk to their primary care doctor about a possible concussion or contact the UPMC Sports Medicine Concussion Program at 412-432-3681.