10 Things You Need To Know About Concussion In Older Adults

by Karen D. Sullivan, PhD, ABPP

Concussion is a mild form of traumatic brain injury and common in older adults due to fall or motor vehicle accident. When the head is hit or jolted with substantial force, the brain moves back and forth rapidly in the skull, which can cause diffuse injury and chemical changes in the brain. A concussion occurs when someone briefly loses consciousness (“knocked out,” “blacked out”) or feels suddenly confused and/or disoriented (“seeing stars,” feeling like you got your “bell rung”).

Concussions can cause a variety of symptoms including physical (headache, nausea, dizziness, fatigue), sensory (sensitivity to noise and light), cognitive (confusion, trouble concentrating, slowed thinking) and emotional issues (irritability and depression). Keep this list handy to help you best respond to a concussion if you or a loved one should unfortunately sustain one.

  1. Know when to seek emergency care. Symptoms that involve a prolonged loss of consciousness/responsiveness, extreme nausea, severe headache, glossy eyes, weakness, vomiting or a significant worsening of symptoms require emergency care, as they may be signs of brain swelling or bleeding. Only a physician and a CT scan of the head can rule these out.
  2. Effect of blood thinners. Even a minor bump on the head can be dangerous for people taking blood thinners, such as warfarin (Coumadin) or daily aspirin. These people should be evaluated in emergency care even when they do not have any symptoms.
  3. Trauma gets worse with age. Just like our bones are at risk for more damage following a fall as we age, so are our brains. Recovery may also be slower and require specialized care by providers with expertise in geriatrics.
  4. Memory symptoms are normal, at first. Almost everyone with a concussion will experience memory symptoms including memory lapses before, during or immediately after the event and difficulty remembering recent information. If these symptoms persist beyond a few weeks, it’s time to be evaluated.
  5. The power of rest. In the first week following a concussion, it is essential to let your body and brain rest. Treat yourself as if you have the flu. Get extra sleep, eat well, avoid significant exertion and gradually return to your daily activities. If symptoms persist beyond three weeks, seek treatment.
  6. There are no medicines for concussion. There are no medications to treat the concussion injury; however, there are medications to ease the symptoms while you recover including headache, nausea, dizziness or pain.
  7. Avoid a second concussion within next few weeks. Avoid situations that could lead to another concussion before the first one heals. A second concussion can lead to “second impact syndrome,” which is a very rare condition causing rapid and severe brain swelling and often devastating outcomes including death.
  8. Fall prevention. Use your walker or cane consistently, if your doctor has made the recommendation. Regular, safe cardiovascular exercise is essential to remaining fall-free in older adulthood. Physical therapy to improve balance and strength is an excellent idea. Wear sensible shoes with a non-slip grip on the sole.
  9. Talk to your primary care physician about your concussion history. In general, a history of multiple concussions, even if spaced over years, can cause serious long-term problems, including chronic headache, poor balance, poor concentration and an increased risk of dementia.
  10. Evaluation with a concussion specialist. Research tells us that early evaluation by a neuropsychologist and education are critical for an optimal recovery and preventing further damage.


Dr. Sullivan, a clinical neuropsychologist at Pinehurst Neuropsychology, can be reached at 910-420-8041 or www.pinehurstneuropsychology.com.