Geriatric Considerations: Age-Related Functional Changes in Acquired Neurologic Injury

Aging is the time-dependent, sequential deterioration that occurs in living beings. Age-related loss of function includes weakness, increased susceptibility to disease and adverse environmental conditions, loss of mobility and agility, and significant physiological changes. Falls are the leading cause of traumatic brain injury in older adults, with over one-third of older adults experiencing a fall annually, leading to significant morbidity and mortality. Aging is associated with worse treatment outcomes after acquired brain injury and spinal cord injury, with older adults more likely to have pre-existing medical conditions that influence patient outcomes. Patients aging with pre-morbid disability note increased functional changes that lead to a loss of independence, requiring reassessment of durable medical equipment and techniques used for mobility and self-care. The acute care consultant needs to be aware of the challenges older individuals face following acquired neurologic injury to tailor the goals of the rehabilitation program appropriately. This chapter will summarize age-related functional changes and how they are associated with acquired neurologic injury.