Fisher Center for Alzheimer’s Research – Elderly men and women who suffer traumatic brain injuries—most often the result of a fall—are at increased risk of developing dementia, a new study found.
They are also far more likely to need home health services or admission to a long-term care facility than their peers who didn’t suffer such an injury.
“One of the most common reasons for traumatic brain injury in older adulthood is sustaining a fall, which is often preventable,” the authors write in the Canadian Medical Association Journal. “By targeting fall-related traumatic brain injuries, we can potentially reduce traumatic brain injury-associated dementia in this population.”
Traumatic brain injuries can occur when the head hits the floor, ground or a piece of furniture, or the head is hit directly by a ball or another object. They can also be the result of an indirect force, such as whiplash after a car accident. Concussions are one example of a traumatic brain injury. Signs of a traumatic brain injury include loss of consciousness, disorientation or neurological signs like slurred speech, muscle weakness or vision changes.
For the study, researchers analyzed data on more than 260,000 elderly adults living in Ontario, Canada. Their mean age was 77. Half had suffered a traumatic brain injury at some point between April 2004 and March 2020. They were followed for up to 17 years.
Compared to their peers who had not suffered a traumatic brain injury, a new traumatic brain injury was associated with a 69 percent increased risk of subsequent dementia in the first five years after the injury, and a 56 percent increased risk beyond five years. Advancing age increased the risk, with about one in three people age 85 and older predicted to develop dementia after a traumatic brain injury.
Earlier research had established traumatic brain injury as a risk factor for dementia in younger adults. “Our findings emphasize its significant association with an increased rate of incident dementia, even when it is sustained in late life,” the authors write. “This critical information can assist clinicians in guiding older patients and their families to better understand long-term risks.”
Falls and dementia may also be a two-way street. Older adults with cognitive decline, as well as those with full-blown Alzheimer’s disease, are more likely to have a fall. But trauma from those falls may also accelerate dementia’s progression and make a diagnosis more likely down the line.
Experts recommend that tests of memory and thinking skills be performed in older adults who have a fall that is serious enough to require a visit to the emergency room or admission to a hospital. Such cognitive screenings are often a first step leading to a diagnosis of Alzheimer’s disease.
It is also vitally important to take steps to help prevent falls in the first place, or to minimize their impact. Among the steps that experts recommend:
- Fall-proof your home. Remove stacks of papers, loose carpets, extension cords or dropped clothing items that may be on the floor. Promptly wipe up spills of water or other liquids in the kitchen or bathroom, since they can be slippery and increase the risk of falls. Keep some lights on at night.
- Maintain your focus. Stay focused when getting into challenging activities, such as getting into the bathtub or going up or down stairs. Wear shoes that are easy and comfortable without being loose, and avoid shoes with loose ties.
- Keep a list of your medications. Prescription drugs as well as over-the-counter medicines and dietary supplements can cause drowsiness or have other side effects that can diminish attention and increase the risk of falls. Keep the list of medications with you, so that your doctor can check for interactions or side effects if any new medications are added to your regimen.
- Monitor your blood pressure. Low blood pressure, especially when you suddenly stand up, cause result in dizziness or loss of balance and lead to falls.
- Consider strength and balance exercises. Regular exercise and physical activity, even if it is light, can help to maintain muscle strength and balance and may help to minimize the risk of falls. Treadmill training and tai chi can be good ways to build balance.
By ALZinfo.org, The Alzheimer’s Information Site. Reviewed by Eric Schmidt, Ph.D., Fisher Center for Alzheimer’s Research Foundation at The Rockefeller University.
Source: Yu Qing Huang, Manav V. Vyas, Susan E. Bronskill, et al: “Rate of incident dementia and care needs among older adults with new traumatic brain injury: a population-based cohort study.” Canadian Medical Association Journal, October 6, 2025
