Outcome following traumatic brain injury in the elderly: a critical review.
BACKGROUND
The elderly are at risk for traumatic brain injury (TBI), but their outcome following these injuries remains unclear.


OBJECTIVE
This paper critically reviews research done to date on cognitive and functional outcome following TBI in the elderly.


METHODS
MEDLINE and PSYCHLIT databases going back to 1965 were searched.


RESULTS
Studies suggest that TBI results in adverse cognitive and functional outcomes in the elderly. There is uncertainty as to whether TBI is a significant risk factor for Alzheimer's disease (AD). Methodological problems in these studies include selection bias, small samples, retrospective analyses, and, particularly, the failure to address the role of pre-morbid functioning. These problems limit the strength of the outcome studies, and may account for the equivocal findings on AD risk.


CONCLUSIONS
It is premature to conclude from the published research to date that the elderly have a uniformly poor outcome following TBI. Directions for further research are suggested.
Rapoport
M J
MJ
University of Toronto, Sunnybrook and Women's Health Sciences Centre, Ontario, Canada.
Feinstein
A
A
D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis; D001930:Brain Injuries / Q000175:diagnosis* / Q000534:rehabilitation; D020208:Brain Injury, Chronic / Q000175:diagnosis* / Q000534:rehabilitation; D004185:Disability Evaluation; D005500:Follow-Up Studies; D006801:Humans; D009483:Neuropsychological Tests