Healthy Aging with Traumatic Brain Injury: Difference between revisions
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== Life Expectancy following TBI == | == Life Expectancy following TBI == | ||
A very large study<ref>Brooks JC, Shavelle RM, Strauss DJ, Hammond FM, Harrison-Felix CL. 2015 | A very large study <ref>Brooks JC, Shavelle RM, Strauss DJ, Hammond FM, Harrison-Felix CL. 2015 | ||
Long-Term Survival After Traumatic Brain Injury Part II: Life Expectancy. | Long-Term Survival After Traumatic Brain Injury Part II: Life Expectancy. | ||
Arch Phys Med Rehabil. 2015 Jun;96(6):1000-5. doi: 10.1016/j.apmr.2015.02.002. | Arch Phys Med Rehabil. 2015 Jun;96(6):1000-5. doi: 10.1016/j.apmr.2015.02.002. | ||
</ref> looked at the life expectancy of people with | </ref> looked at the life expectancy of people with traumatic brain injury in comparison to the general population in the USA found that the life expectancy of people with traumatic brain injury varied enormously, from < 40% of normal life expectancy for individuals with a traumatic brain injury who were non-ambulant and dependent on others for feeding, to > 85% for those who were independently mobile.<div align="justify"> | ||
== Effects of Increasing Age with TBI == | == Effects of Increasing Age with TBI == | ||
==== Effects on Cognition ==== | ==== Effects on Cognition ==== | ||
<div align="justify"> | <div align="justify"> | ||
People who have had moderate or severe | People who have had moderate or severe traumatic brain injury are known to have an increased risk of decline of cognitive abilities, and increased risk of dementia, later in life. One 2015 study <ref name=":0">Cole JH, Leech R, Sharp DJ. | ||
Prediction of brain age suggests accelerated atrophy after traumatic brain injury. | Prediction of brain age suggests accelerated atrophy after traumatic brain injury. | ||
Annals of Neurology, Vol 77, Issue 4. | Annals of Neurology, Vol 77, Issue 4. | ||
</ref> compared MRI brain scans of people with | </ref> compared MRI brain scans of people with traumatic brain injury to a control group; they developed a computer program with an algorithm to estimate the persons "brain age", and the people with traumatic brain injury were found to have a brain age on average 5 years older than the control group. The authors note: "There was also a correlation between time since injury and predicted age difference, suggesting that these changes in brain structure do not occur during the injury itself, but result from ongoing biological processes, potentially similar to those seen in normal ageing, that progress more quickly after an injury." | ||
This suggests that after | This suggests that after traumatic brain injury there may be secondary process, which leads to increased brain damage for years afterwards. <ref name=":0" /> | ||
===== Dementia ===== | ===== Dementia ===== | ||
There is evidence that a | There is evidence that a traumatic brain injury earlier in life increases the risk of developing [https://physio-pedia.com/Dementia dementia] of the Alzheimer's type in old age. <ref>Z. Guo, L.A. Cupples, A. Kurz, S.H. Auerbach, L. Volicer, H. Chui, ''et al.'' | ||
Head injury and the risk of AD in the MIRAGE study | Head injury and the risk of AD in the MIRAGE study | ||
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Documented head injury in early adulthood and risk of Alzheimer's disease and other dementias | Documented head injury in early adulthood and risk of Alzheimer's disease and other dementias | ||
Neurology, 55 (2000), pp. 1158- | Neurology, 55 (2000), pp. 1158- | ||
</ref> | </ref><div align="justify"><div align="justify"> | ||
==== Effects on Physical Condition ==== | ==== Effects on Physical Condition ==== | ||
People with moderate or severe | People with moderate or severe traumatic brain injury can experience increased musculoskeletal deterioration with aging, more than occurs in the general non-traumatic brain injurypopulation. Frequently this occurs due to the nature of the accident/incident which caused the traumatic brain injury, such as road traffic accident, also causing bony and soft tissue damage to trunk and/or limbs. | ||
=== Frailty in Elderly People === | === Frailty in Elderly People === | ||
Definition: “[[Frailty: Theoretical Frameworks|Frailty]] is a clinical state in which there is an increase in an individual’s vulnerability for developing increased dependency and/or mortality when exposed to a stressor.”<ref>Morley JE, Vellas B, Abellan van Kan G, Anker SD, Bauer JM, Bernabel R et al. | Definition: “[[Frailty: Theoretical Frameworks|Frailty]]" is a clinical state in which there is an increase in an individual’s vulnerability for developing increased dependency and/or mortality when exposed to a stressor.” <ref>Morley JE, Vellas B, Abellan van Kan G, Anker SD, Bauer JM, Bernabel R et al. | ||
Frailty consensus: a call to action. | Frailty consensus: a call to action. | ||
J Am Med Dir Assoc. 2013. 14(6): 392-7. | J Am Med Dir Assoc. 2013. 14(6): 392-7. | ||
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==== Sarcopenia ==== | ==== Sarcopenia ==== | ||
This is defined as loss of muscle function, strength and mass; it is a normal consequence of growing older, and in some people with | This is defined as loss of muscle function, strength and mass; it is a normal consequence of growing older, and in some people with traumatic brain injury an increase in sarcopenia when compared to the general population may be seen as a result of reduced physical activity and exercise levels. | ||
==== Osteopenia/ | ==== Osteopenia / Osteoporosis ==== | ||
[[Osteoporosis]] is a characterized by a decrease in bone density which results in bones become increasingly porous and brittle leading to increased risk of fracture. Osteoporosis is a major health threat across the globe<ref>Johnell O and Kanis JA (2006) An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 17:1726</ref> | [[Osteoporosis]] is a characterized by a decrease in bone density which results in bones become increasingly porous and brittle leading to increased risk of fracture. Osteoporosis is a major health threat across the globe. <ref>Johnell O and Kanis JA (2006) An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 17:1726</ref> | ||
Osteopenia is a milder reduction in bone density, which can be described as being a midpoint between having healthy bones and osteoporosis. In osteopenia the bones are weaker than normal, but not sufficiently weak that they fracture easily (as they do in osteoporosis). | Osteopenia is a milder reduction in bone density, which can be described as being a midpoint between having healthy bones and osteoporosis. In osteopenia the bones are weaker than normal, but not sufficiently weak that they fracture easily (as they do in osteoporosis). | ||
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People who are taking anti-epileptic medication are known to have an increased risk of osteopenia and osteoporosis, and so people with seizures following TBI who take such medication have a markedly increased risk. | People who are taking anti-epileptic medication are known to have an increased risk of osteopenia and osteoporosis, and so people with seizures following TBI who take such medication have a markedly increased risk. | ||
The incidence of osteopenia increases with age, with most people losing approximately '''.'''5% of bone mass every year after the age of 50.<div align="justify"> | The incidence of osteopenia increases with age, with most people losing approximately '''.'''5% of bone mass every year after the age of 50. | ||
== Physical Activity == | |||
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<div align="justify"><div align="justify"><div align="justify"><div align="justify"> | |||
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<div align="justify"><div align="justify"> | <div align="justify"><div align="justify"> | ||
The amount of physical activity [PA] which any person with traumatic brain injury engages in, has a great impact on healthy ageing, just as it does in the general population. | |||
The amount of physical activity [PA] which any person with | |||
The [https://physio-pedia.com/Benefits_of_Physical_Activity health benefits of | The [https://physio-pedia.com/Benefits_of_Physical_Activity health benefits of Physical Activity] are shown below: | ||
[[File:Physical_and_mental_health_benefits.png|frameless|900x900px]] | [[File:Physical_and_mental_health_benefits.png|frameless|900x900px]] | ||
Other benefits include a decrease in the risks of secondary conditions, such as hypertension, [https://physio-pedia.com/Osteoporosis osteoporosis], and [https://physio-pedia.com/Cardiovascular_Disease#sts=What%20are%20cardiovascular%20diseases? cardiovascular disease]<ref name=":1">Irwin, Kelley BS; Ede, Alison MS; Buddhadev, Harsh BPT et al. | Other benefits include a decrease in the risks of secondary conditions, such as hypertension, [https://physio-pedia.com/Osteoporosis osteoporosis], and [https://physio-pedia.com/Cardiovascular_Disease#sts=What%20are%20cardiovascular%20diseases? cardiovascular disease.] <ref name=":1">Irwin, Kelley BS; Ede, Alison MS; Buddhadev, Harsh BPT et al. | ||
Physical Activity and Traumatic Brain Injury | Physical Activity and Traumatic Brain Injury | ||
Strength and Conditioning Journal: August 2011 - Volume 33 - Issue 4 - p 43-47 doi: 10.1519/SSC.0b013e318210e899 | Strength and Conditioning Journal: August 2011 - Volume 33 - Issue 4 - p 43-47 doi: 10.1519/SSC.0b013e318210e899 | ||
</ref> | </ref> | ||
==== Physical Activity in the | ==== Physical Activity in the Traumatic Brain Injury Population ==== | ||
People with | People with traumatic brain injury have been found to have fitness levels well below the lowest fitness levels of adults, matched for age and sex. <ref>Hassett L, Moseley AM, Harmer AR. Fitness training for cardiorespiratory conditioning after traumatic brain injury. Cochrane Database of Systematic Reviews 2017, Issue 12. Art. No.: CD006123. DOI: 10.1002/14651858.CD006123.pub3</ref> | ||
Studies have demonstrated that the | Studies have demonstrated that the traumatic brain injury population benefit from aerobic conditioning and strength training <ref name=":1" />, specifically: | ||
* An increase in aerobic capacity <ref>Jankowski LW and Sullivan SJ. | * An increase in aerobic capacity <ref>Jankowski LW and Sullivan SJ. | ||
Aerobic and neuromuscular training: Effect on the capacity, efficiency, and fatigability of patients with traumatic brain injuries. | Aerobic and neuromuscular training: Effect on the capacity, efficiency, and fatigability of patients with traumatic brain injuries. | ||
| Line 77: | Line 79: | ||
''Arch Phys Med Rehabil'' 71: 500-504, 1990. | ''Arch Phys Med Rehabil'' 71: 500-504, 1990. | ||
</ref> | </ref> | ||
* Increase in muscle strength and endurance<ref>Bhambhani Y, Rowland G, and Farag M. | * Increase in muscle strength and endurance <ref>Bhambhani Y, Rowland G, and Farag M. | ||
Effects of circuit training on body composition and peak cardiorespiratory responses in patients with moderate to severe traumatic brain injury. | Effects of circuit training on body composition and peak cardiorespiratory responses in patients with moderate to severe traumatic brain injury. | ||
''Arch Phys Med Rehabil'' 86: 268-276, 2005. | ''Arch Phys Med Rehabil'' 86: 268-276, 2005. | ||
</ref> | </ref> | ||
* Reduced risk of secondary conditions - cardiovascular disease, osteoporosis, hypertension<ref>U.S. Department of Health and Human Services. 2008 physical activity guidelines for Americans. 2009. Available at: http://www.health.gov/PAGuidelines/pdf/paguide.pdf. Accessed 1 September 2019.</ref> | * Reduced risk of secondary conditions - cardiovascular disease, osteoporosis, hypertension <ref>U.S. Department of Health and Human Services. 2008 physical activity guidelines for Americans. 2009. Available at: http://www.health.gov/PAGuidelines/pdf/paguide.pdf. Accessed 1 September 2019.</ref> | ||
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== References == | == References == | ||
Revision as of 21:49, 18 September 2019
Original Editor - Wendy Walker
Top Contributors - Wendy Walker, Naomi O'Reilly, Admin, Kim Jackson, Uchechukwu Chukwuemeka, Lucinda hampton, Tarina van der Stockt, Jess Bell, Stacy Schiurring, Rachael Lowe and Simisola Ajeyalemi
Life Expectancy following TBI[edit | edit source]
A very large study [1] looked at the life expectancy of people with traumatic brain injury in comparison to the general population in the USA found that the life expectancy of people with traumatic brain injury varied enormously, from < 40% of normal life expectancy for individuals with a traumatic brain injury who were non-ambulant and dependent on others for feeding, to > 85% for those who were independently mobile.Effects of Increasing Age with TBI[edit | edit source]
Effects on Cognition[edit | edit source]
People who have had moderate or severe traumatic brain injury are known to have an increased risk of decline of cognitive abilities, and increased risk of dementia, later in life. One 2015 study [2] compared MRI brain scans of people with traumatic brain injury to a control group; they developed a computer program with an algorithm to estimate the persons "brain age", and the people with traumatic brain injury were found to have a brain age on average 5 years older than the control group. The authors note: "There was also a correlation between time since injury and predicted age difference, suggesting that these changes in brain structure do not occur during the injury itself, but result from ongoing biological processes, potentially similar to those seen in normal ageing, that progress more quickly after an injury."
This suggests that after traumatic brain injury there may be secondary process, which leads to increased brain damage for years afterwards. [2]
Dementia[edit | edit source]
There is evidence that a traumatic brain injury earlier in life increases the risk of developing dementia of the Alzheimer's type in old age. [3][4][5]Effects on Physical Condition[edit | edit source]
People with moderate or severe traumatic brain injury can experience increased musculoskeletal deterioration with aging, more than occurs in the general non-traumatic brain injurypopulation. Frequently this occurs due to the nature of the accident/incident which caused the traumatic brain injury, such as road traffic accident, also causing bony and soft tissue damage to trunk and/or limbs.
Frailty in Elderly People[edit | edit source]
Definition: “Frailty" is a clinical state in which there is an increase in an individual’s vulnerability for developing increased dependency and/or mortality when exposed to a stressor.” [6] It is commonly thought to be a result of a combination of the following:
Sarcopenia[edit | edit source]
This is defined as loss of muscle function, strength and mass; it is a normal consequence of growing older, and in some people with traumatic brain injury an increase in sarcopenia when compared to the general population may be seen as a result of reduced physical activity and exercise levels.
Osteopenia / Osteoporosis[edit | edit source]
Osteoporosis is a characterized by a decrease in bone density which results in bones become increasingly porous and brittle leading to increased risk of fracture. Osteoporosis is a major health threat across the globe. [7]
Osteopenia is a milder reduction in bone density, which can be described as being a midpoint between having healthy bones and osteoporosis. In osteopenia the bones are weaker than normal, but not sufficiently weak that they fracture easily (as they do in osteoporosis).
People who are taking anti-epileptic medication are known to have an increased risk of osteopenia and osteoporosis, and so people with seizures following TBI who take such medication have a markedly increased risk.
The incidence of osteopenia increases with age, with most people losing approximately .5% of bone mass every year after the age of 50.
Physical Activity[edit | edit source]
The amount of physical activity [PA] which any person with traumatic brain injury engages in, has a great impact on healthy ageing, just as it does in the general population.
The health benefits of Physical Activity are shown below:
Other benefits include a decrease in the risks of secondary conditions, such as hypertension, osteoporosis, and cardiovascular disease. [8]
Physical Activity in the Traumatic Brain Injury Population[edit | edit source]
People with traumatic brain injury have been found to have fitness levels well below the lowest fitness levels of adults, matched for age and sex. [9]
Studies have demonstrated that the traumatic brain injury population benefit from aerobic conditioning and strength training [8], specifically:
- An increase in aerobic capacity [10]
- Increase in muscle strength and endurance [11]
- Reduced risk of secondary conditions - cardiovascular disease, osteoporosis, hypertension [12]
References[edit | edit source]
- ↑ Brooks JC, Shavelle RM, Strauss DJ, Hammond FM, Harrison-Felix CL. 2015 Long-Term Survival After Traumatic Brain Injury Part II: Life Expectancy. Arch Phys Med Rehabil. 2015 Jun;96(6):1000-5. doi: 10.1016/j.apmr.2015.02.002.
- ↑ 2.0 2.1 Cole JH, Leech R, Sharp DJ. Prediction of brain age suggests accelerated atrophy after traumatic brain injury. Annals of Neurology, Vol 77, Issue 4.
- ↑ Z. Guo, L.A. Cupples, A. Kurz, S.H. Auerbach, L. Volicer, H. Chui, et al. Head injury and the risk of AD in the MIRAGE study Neurology, 54 (2000), pp. 1316-
- ↑ J.A. Mortimer, C.M. Vanduijn, V. Chandra, L. Fratiglioni, A.B. Graves, A. Heyman, et al. Head trauma as a risk factor for Alzheimers-disease—a collaborative reanalysis of case-control studies Int J Epidemiol, 20 (1991), pp. S28-S35
- ↑ B.L. Plassman, R.J. Havlik, D.C. Steffens, M.J. Helms, T.N. Newman, D.Drosdick, et al. Documented head injury in early adulthood and risk of Alzheimer's disease and other dementias Neurology, 55 (2000), pp. 1158-
- ↑ Morley JE, Vellas B, Abellan van Kan G, Anker SD, Bauer JM, Bernabel R et al. Frailty consensus: a call to action. J Am Med Dir Assoc. 2013. 14(6): 392-7.
- ↑ Johnell O and Kanis JA (2006) An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 17:1726
- ↑ 8.0 8.1 Irwin, Kelley BS; Ede, Alison MS; Buddhadev, Harsh BPT et al. Physical Activity and Traumatic Brain Injury Strength and Conditioning Journal: August 2011 - Volume 33 - Issue 4 - p 43-47 doi: 10.1519/SSC.0b013e318210e899
- ↑ Hassett L, Moseley AM, Harmer AR. Fitness training for cardiorespiratory conditioning after traumatic brain injury. Cochrane Database of Systematic Reviews 2017, Issue 12. Art. No.: CD006123. DOI: 10.1002/14651858.CD006123.pub3
- ↑ Jankowski LW and Sullivan SJ. Aerobic and neuromuscular training: Effect on the capacity, efficiency, and fatigability of patients with traumatic brain injuries. Arch Phys Med Rehabil 71: 500-504, 1990.
- ↑ Bhambhani Y, Rowland G, and Farag M. Effects of circuit training on body composition and peak cardiorespiratory responses in patients with moderate to severe traumatic brain injury. Arch Phys Med Rehabil 86: 268-276, 2005.
- ↑ U.S. Department of Health and Human Services. 2008 physical activity guidelines for Americans. 2009. Available at: http://www.health.gov/PAGuidelines/pdf/paguide.pdf. Accessed 1 September 2019.
