The Epidemiology of Traumatic Brain Injury in Pennsylvania: Treatment and Outcome Differences by Age and Geographic Location

Open Access
Author:
Ramanathan, Deepa
Graduate Program:
Psychology
Degree:
Doctor of Philosophy
Document Type:
Dissertation
Date of Defense:
May 23, 2012
Committee Members:
  • Frank Gerard Hillary, Dissertation Advisor
  • Peter Andrew Arnett, Committee Member
  • Stephen Jeffrey Wilson, Committee Member
  • Nilam Ram, Special Member
Keywords:
  • Traumatic Brain Injury
  • Head Injury
  • Epidemiology
  • Geriatrics
  • Older Adults
  • Functional Outcome
  • Fall Prevention
Abstract:
Older adults tend to have poorer outcomes compared to younger adults following moderate to severe traumatic brain injury (TBI). Currently, there is a need for research focusing on how elderly TBI incidence and outcome has changed over time as the U.S. population shifts. To provide an epidemiological account of elderly TBI, the Pennsylvania Trauma Outcome Study (including data collected between 1992 and 2009) was used. The results indicated that the incidence of elderly TBI has approximately doubled in the past 18 years and that, within the elderly sample, the increase in TBI is greatest for individuals between the ages of 83 and 90. This study also demonstrated that, although elderly age independently predicted TBI incidence rates and outcomes, the geographic location of the injury is also important to consider when examining fatalities and do-not-resuscitate orders. Lastly, when comparing a number of subgroups, the results showed that elderly rural males above the age of 83 had the worst outcomes following TBI, when fatalities and functional scores at discharge were examined. Young adults in urban areas sustained the most severe injuries in Pennsylvania. Prevention and awareness of TBI in the elderly is imperative to reduce the likelihood of injury and disability. Continued statewide work is needed to demonstrate trends in elderly TBI nationwide to further add to the knowledge base used for prevention and rehabilitation work.