FALLS PREVENTION PROGRAM NETWORK MEETING, DEPARTMENT
OF HUMAN SERVICES, VICTORIA - 27 AUGUST, 2009
FALLS-RELATED TRAUMATIC BRAIN
INJURY IN OLDER AUSTRALIANS
Nick Rushworth
Executive Officer Brain Injury Australia
ACQUIRED BRAIN INJURY (ABI)
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style just about the
never
any damage to the brain that occurs after birth
It’s
numbers, but…
 stroke
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 brain infection
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 alcohol or other drug abuse
 neurological diseases like Huntington's
disease
 accident or trauma
over 500,000 Australians have an Acquired Brain Injury
Nick Rushworth
7/31/2017
Executive Officer Brain Injury Australia
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Brain Injury Network of South
Australia AGM, 2008
TRAUMATIC BRAIN INJURY (TBI)
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Topics
Discussion
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subtitle
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State
the
main
ideas
you’ll
be
talking
results from external
force
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style
about
applied to the head from a
motor vehicle accident, a fall or
an assault

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Brain Injury
Injury Network
Network of
of South
South
Australia
AGM,
2008
Australia AGM, 2008
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PHYSICAL
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 headaches
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 fatigue
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feel or think
 seizures
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 poor balance and coordination
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 vision and hearing
disturbance
audience
to remember
 chronic pain
 paralysis
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Brain Injury Network of South
Australia AGM, 2008
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COGNITIVE DISABILITY
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Next Steps
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 poor memory and concentration
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statement
actions that
required of
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your
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audience
how
you
feel or think
reduced ability
this topic
 about
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any follow up action items
- to learn Summarize
required of you
key points you want your
audience to remember
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- to plan and
- to solve problems
Brain Injury Network of South
Australia AGM, 2008
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BEHAVIOUR
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style
 increased irritability
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 poor impulse control
 verbal and physical aggression
 disinhibition
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Brain Injury Network of South
Australia AGM, 2008
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FALLS
leading cause
of
Traumatic
Brain
Injury
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in Australia - 42% of TBI hospitalisations
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in 2004-2005
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 leading cause of injury hospitalisations
overall - 1 in every 3 (126,800) injury
admissions in 2003-2004
 of all causes of TBI, falls are the most
fatal. 63% resulted in death in 2004-2005
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Brain Injury Network of South
Australia AGM, 2008
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FALLS injury in older people
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 65+ accounted
all TBI title
deaths in
style - 1 in every 6 the result of
hospital in 2004-2005
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a fall
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 3,272 TBIs the result of a fall in people aged
65+ = 1 in every 7 TBI hospitalizations in 20042005
 “Head injury” was the second most common
falls-related injury (after those to the hip and
thigh) in 65+ during 2005-2006 (17% of cases)
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Brain Injury Network of South
Australia AGM, 2008
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FALLS injury in older people
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 70,000 aged 65 + admitted to
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hospital in 2005-2006 for a falls
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increase of style
10% over
injury - an
2003-2004 admission numbers
 Falls injuries to the hip and thigh
decreasing, rates of head injury
increasing – to 1 in every 5
admissions
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Brain Injury Network of South
Australia AGM, 2008
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FALLS injury in older people
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 2003-2004;style
cost of hospitalised falls
in
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people aged 65+ estimated
atMaster
$566subtitle
million
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 by 2051, total fall-related injury health
costs for older people to triple to $1.375
billion per annum = an additional 886,000
hospital bed days and 3,320 extra
residential aged care places
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Brain Injury Network of South
Australia AGM, 2008
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FALLS-RELATED TBI in older people
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United States,
2003: direct costs of treating a
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principal diagnosis of TBI in patients aged 65+
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“exceeded $2.2 billion.
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If, as expected, the older population in the
United States doubles from the current 35
million to 70 million by 2030,
the costs of caring for older adults with TBI in
monetary and human terms will be
staggering”
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Brain Injury Network of South
Australia AGM, 2008
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OUTCOMES 1
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 85 plus: highest
age-specific falls injury, falls
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deaths, TBI and TBI death rates (“100% mortality”)
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 age = strongest
clinical predictor of recovery from
subtitle style
TBI (after measures of injury severity)
- every 10 years of age increases “odds on
poor outcome” 40% - 50%
- “optimal change points” in age at TBI were 60
years (mortality), 29 years (“unfavorable
outcome“)
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Brain Injury Network of South
Australia AGM, 2008
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OUTCOMES
2
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 3X risk of intracranial bleeding than younger TBI
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 2X length of hospital stay
 longer periods ofClick
Post-Traumatic
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 increased risk of subtitle
developing
style Alzheimer’s Disease
 only 30%-50% returned directly home
 increased risk of residential aged care placement
 higher incidence of general brain deterioration
 reduced psychosocial and financial support
 "lowered expectations for recovery by staff and
patient"
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Brain Injury Network of South
Australia AGM, 2008
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“…it is worth
that many
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TBI’s in older
people occur among
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those who already Click
have
a measure
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of neurodegenerative disease and
especially among those in resicare
– the majority already have
disabling dementia…”
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Brain Injury Network of South
Australia AGM, 2008
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“…you are probably correct in
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stating thatClick
TBI to
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elderly[sic]
tends to getstyle
mixed in with dementia
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and mild cognitive impairment…
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Of course a significant proportion of
the falls that occur in the elderly[sic]
happen in persons with dementia
and any added TBI is seen as a
dementia complication…”
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Brain Injury Network of South
Australia AGM, 2008
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TBI PREVENTION
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 65+ men - ladders,
style“DIY” (up 25%, 1999-2005)
 falls “from heights”
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 women – (outlive men), Click
hometo
hazards
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 “old old” – residential aged care (5X rate at home)
 “hit head” or no?
 neurological observations (72 hours+?)
 anti-thrombotics use, intracranial bleeding (…200506 - 21,000 scripts for warfarin issued to 80 yrs+)
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Brain Injury Network of South
Australia AGM, 2008
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NAME RECOGNITION
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 falls prevention
programs
–
why?
style
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injury” second
style to hip
 “head
fracture in falls injury
 ageing population + increased
life expectancy
 “baby boomers”
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Brain Injury Network of South
Australia AGM, 2008
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www.braininjuryaustralia.org.au
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Australia AGM, 2008
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