57. Concussion in Older Adults: Patient Characteristics and Key Clinical Considerations for Neuropsychologists

Abstract

Abstract Purpose To describe the characteristics and clinical presentation of a large sample of concussed older adults, and to outline key considerations for providing specialty concussion care to this population. Method An EMR review was conducted of older adult patients (65-95years) treated between 2020 and 2026. Results A total of 196 patients presented for their first clinical visit 40.0 days following injury (SD=73.5, Range=2-736). Their average age was 72 years (SD=5.83), 69% were female, and most of the sample was White (65%). The prevalence of concussion (26%), migraine (26%), depression (33%), and anxiety history (40%) were similar across the sample, and 5.6% reported ADHD and/or LD diagnoses. Overall, 72% exhibited high symptom burden, 26% presented with moderate-to-severe anxiety, and 33% exceeded clinical cutoffs for depression. Most of the sample (77%) reported a moderate-to-high concern of falling, and 71% exhibited vestibular/ocular motor impairment. The Montreal Cognitive Assessment was indicated for 41% of the sample and mild cognitive impairment was detected in 14%. A total of 190 patients returned for clearance with a recovery time of 80 days (SD=85.7, Range=4-550). Conclusions Although the TBI literature for older adults suggests complex, long-term outcomes, these data suggest that concussed older adults may show similar symptoms and recovery patterns as younger adults when they receive specialty concussion care. Using measures normed for older adults allows for collection of clinically meaningful data to support individualized treatment planning and recovery. More research is needed to clarify normal recovery timelines and prevalent risk factors for prolonged recovery in this unique population.