Life Span Issues in Brain Injury
As more individuals survive severe brain injury and live for decades beyond their injury, we are seeing the effects of brain injury accross the lifespan. For many of us who started out in brain injury rehabilitation in the 1970’s, we are aging with the people we serve.
At the recent Iowa Brain Inujry Association Conference in Des Moines, I had the opportunity to speak with Randy Evans, Ph.D. who has a substantial history in research and innovative work in brain injury. Dr. Evans shared with me some data from the Veteran’s Administration Study involving 1776 W.W.II vets who experienced a brain injury in 1944-45. 548 of the individuals in the study had a traumatic brain injury as noted in their medical records. These individuals are now sixty years post-injury and likely to be in their eighties.
Dr. Evans presented this study with Brenda Plassman, Ph.D. at the recent 2nd Federal Traumatic Brain Injury Interagency Conferece and offered some memorable findings:
–The long term study is significant in terms of a substantially elevated risk of Alzheimer’s Dementia.
–The risk of depression increased for the veteran’s group with a lifetime prevalence rate of 18.5% among TBI survivors vs 13.4% in those without TBI. Also, the likelihood of depression was linked to severity of injury.
–While the prevalence of stroke (CVA) was not more common in those with wartime TBI, severe brain injury was associated with a higher stroke risk.
–PTSD was observed at a higher rate in individuals with TBI.In short, TBI created several significant risks for neurologic and behavioral health problems over the course of time.
We know what causes long term cognitive impairments: initial damage, further degeneration, decades of stress on remaining brain tissue, and the effects of aging on an injured brain. A brain injury does not automatically mean that the person will experience Alzheimer’s Disease, depression, PTSD or stroke, but it does indicate that these conditions have a greater likelihood of occurring. We also know that physical decline, the emergence of health problems, problems with community access and housing and social network problems are likely to affect the lives of individuals with TBI as they grow older.
Thousands of our veterans are aging with a brain injury. Vietnam era veterans living with a brain injury are now in their sixties, and a new group of injured individuals from the Iraq war are emerging. We also have a civilian population, who without the war-related injuries, are experiencing similar problems to the veteran groups as they age. Moreover, there are children who are injured and will live through their childhood and adult lives with the effects of a brain injury. The information regarding the lifetime issues experienced by individuals with TBI is here now. We need to pay attention to these individuals and develop the resources and services which they will need long after rehabilitation has ended.