Traumatic brain injury isn’t just a young‑guy‑playing‑sports problem. This week on Speech Talk, we’re diving into TBI in older adults—a population with the highest rates of hospitalization, morbidity, and mortality related to brain injury.

Using the ASHA review Traumatic Brain Injury in Older Adults: Epidemiology, Etiology, Rehabilitation, and Outcomes, we break down why TBIs are so common (and so often missed) in geriatrics, especially in SNFs and hospital settings. From falls and car accidents without a concussion diagnosis, to chronic health conditions and polypharmacy, this episode connects the dots between normal aging and TBI‑related cognitive‑communication changes.

We talk through what TBIs actually look like in older adults, how to tell aging apart from injury, what assessments clinicians are really using in rehab, and how functional, fall‑focused, real‑world therapy can make a difference. If you’ve ever felt underprepared when a “no concussion noted” patient suddenly isn’t making sense—this one’s for you.

You’ll learn:

Why older adults have the highest risk and worst outcomes related to TBI

The most common causes of TBI in geriatrics—and why falls dominate the picture

How TBI presentations differ from typical age‑related cognitive changes

Key cognitive‑communication, executive function, and neurobehavioral red flags

Chronic health factors that increase TBI risk and complicate recovery

Common assessments used with older adults after TBI (SLUMS, MoCA, SCATBI)

Practical, functional treatment strategies that translate to real life

Why fall education and environmental awareness matter so much in SNFs

Citations:
Most of today’s data comes from a 2022 ASHA review synthesizing multiple large epidemiologic studies on traumatic brain injury in older adults.

Mattingly, E., & Roth, C. R. (2022). Traumatic brain injury in older adults: Epidemiology, etiology, rehabilitation, and outcomes. Perspectives of the ASHA Special Interest Groups, 7(3), 648–662. https://doi.org/10.1044/2022_PERSP-21-00129

Albrecht, J. S., McCunn, M., Stein, D. M., Simoni-Wastila, L., & Smith, G. S. (2016). Sex differences in mortality following isolated traumatic brain injury among older adults. Journal of Trauma and Acute Care Surgery, 81(3), 486–492. https://doi.org/10.1097/TA.0000000000001104

Taylor, C. A., Bell, J. M., Breiding, M. J., & Xu, L. (2017). Traumatic brain injury–related emergency department visits, hospitalizations, and deaths—United States, 2007 and 2013. MMWR Surveillance Summaries, 66(9), 1–16. https://doi.org/10.15585/mmwr.ss6609a1

Fu, W. W., Fu, T. S., Jing, R., McFaull, S. R., & Cusimano, M. D. (2017). Predictors of falls and mortality among elderly adults with traumatic brain injury: A nationwide, population-based study. PLOS ONE, 12(4), e0175868. https://doi.org/10.1371/journal.pone.0175868

Bhullar, I. S., Roberts, E. E., Brown, L., & Lipe, H. (2010). The effect of age on blunt traumatic brain-injured patients. The American Surgeon, 76(9), 966–968.

. The effect of age on blunt traumatic brain‑injured patients. The American Surgeon, 76(9), 966–968.

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