Falls related traumatic brain injury in older australians
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FALLS-RELATED TRAUMATIC BRAIN INJURY IN OLDER AUSTRALIANS PowerPoint PPT Presentation


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FALLS-RELATED TRAUMATIC BRAIN INJURY IN OLDER AUSTRALIANS. FALLS PREVENTION PROGRAM NETWORK MEETING, DEPARTMENT OF HUMAN SERVICES, VICTORIA - 27 AUGUST, 2009. Nick Rushworth Executive Officer Brain Injury Australia. ACQUIRED BRAIN INJURY (ABI) any damage to the brain that occurs after birth

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FALLS-RELATED TRAUMATIC BRAIN INJURY IN OLDER AUSTRALIANS

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Falls related traumatic brain injury in older australians

FALLS-RELATED TRAUMATIC BRAIN INJURY IN OLDER AUSTRALIANS

FALLS PREVENTION PROGRAM NETWORK MEETING, DEPARTMENT OF HUMAN SERVICES, VICTORIA - 27 AUGUST, 2009

Nick Rushworth

Executive Officer Brain Injury Australia


It s never just about the numbers but

  • ACQUIRED BRAIN INJURY (ABI)

  • any damage to the brain that occurs after birth

  • stroke

  • brain infection

  • alcohol or other drug abuse

  • neurological diseases like Huntington's disease

  • accident or trauma

    over 500,000 Australians have an Acquired Brain Injury

It’s never just about the numbers, but…

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Nick Rushworth

Executive Officer Brain Injury Australia

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6/4/2014

Brain Injury Network of South Australia AGM, 2008

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TRAUMATIC BRAIN INJURY (TBI)

results from external force applied to the head from a motor vehicle accident, a fall or an assault

Topics of Discussion

  • State the main ideas you’ll be talking about

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Brain Injury Network of South Australia AGM, 2008

Brain Injury Network of South Australia AGM, 2008

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  • PHYSICAL

  • headaches

  • fatigue

  • seizures

  • poor balance and coordination

  • vision and hearing disturbance

  • chronic pain

  • paralysis

What This Means

  • Add a strong statement that summarizes how you feel or think about this topic

  • Summarize key points you want your audience to remember

6/4/2014

Brain Injury Network of South Australia AGM, 2008

Brain Injury Network of South Australia AGM, 2008

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  • COGNITIVE DISABILITY

  • poor memory and concentration

  • reduced ability

  • - to learn

  • - to plan and

  • - to solve problems

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Next Steps

What This Means

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  • Summarize any actions required of your audience

  • Summarize any follow up action items required of you

  • Add a strong statement that summarizes how you feel or think about this topic

  • Summarize key points you want your audience to remember

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6/4/2014

Brain Injury Network of South Australia AGM, 2008

Brain Injury Network of South Australia AGM, 2008

Brain Injury Network of South Australia AGM, 2008

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  • BEHAVIOUR

  • increased irritability

  • poor impulse control

  • verbal and physical aggression

  • disinhibition

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Brain Injury Network of South Australia AGM, 2008

Brain Injury Network of South Australia AGM, 2008

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FALLS

  • leading cause of Traumatic Brain Injury in Australia - 42% of TBI hospitalisations in 2004-2005

  • 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

Brain Injury Network of South Australia AGM, 2008

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FALLS injury in older people

  • 65+ accounted for 62% of all TBI deaths in hospital in 2004-2005 - 1 in every 6 the result of a fall

  • 3,272TBIs the result of a fall in people aged 65+ = 1 in every 7 TBI hospitalizations in 2004-2005

  • “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)

6/4/2014

Brain Injury Network of South Australia AGM, 2008

Brain Injury Network of South Australia AGM, 2008

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FALLS injury in older people

  • 70,000 aged 65 + admitted to hospital in 2005-2006 for a falls injury - an increase of 10% over 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

Brain Injury Network of South Australia AGM, 2008

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FALLS injury in older people

  • 2003-2004; cost of hospitalised falls in people aged 65+ estimated at $566 million

  • by 2051, total fall-related injuryhealth 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

Brain Injury Network of South Australia AGM, 2008

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FALLS-RELATED TBI in older people

United States, 2003: direct costs of treating a principal diagnosis of TBI in patients aged 65+

“exceeded $2.2 billion.

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

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 deaths, TBI and TBI death rates (“100% mortality”)

  • age = strongest clinical predictor of recovery from 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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OUTCOMES 2

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  • 3X risk of intracranial bleeding than younger TBI

  • 2X length of hospital stay

  • longer periods of Post-Traumatic Amnesia (PTA)

  • increased risk of developing 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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“…it is worth noting that many TBI’s in older people occur among those who already have a measure of neurodegenerative disease and especially among those in resicare – the majority already have disabling dementia…”

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“…you are probably correct in stating that TBI in the elderly[sic] tends to get mixed in with dementia and mild cognitive impairment…

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

  • falls “from heights”

  • 65+ men - ladders, “DIY” (up 25%, 1999-2005)

  • women – (outlive men), home hazards

  • “old old” – residential aged care (5X rate at home)

  • “hit head” or no?

  • neurological observations (72 hours+?)

  • anti-thrombotics use, intracranial bleeding (…2005-06 - 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

  • falls prevention programs – why?

  • “head injury” second to hip 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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Brain Injury Network of South Australia AGM, 2008

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