Aging and Acquired Brain Injury
Amy B. Gonzales, P.A.-C.
ResCare Premier, San Marcos, TX
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Ms. Gonzales received her bachelors degree and Physician Assistant training at the Lake Erie College/ Cleveland Clinic Foundation in Ohio. Amy is nationally certified and state licensed as a Physician Assistant and a fellow of the American Academy of Physician Assistants, Texas Academy of Physician Assistants, and Central Texas Society of Physician Assistants. Ms. Gonzales has been in clinical practice for over 20 years with positions in a wide range of fields including rural medicine, trauma, surgery, adolescent medicine and family practice. Ms. Gonzales is the Manager of Medical Services for ResCare Premier.

"The years teach much which the days never knew."
-Ralph Waldo Emerson

Life Expectancy Over the Years

Before 1900 Less than 30 years old
1900 48 years old
20th Century 30 more additional years
Today An average of 77 years old
(80 yrs. for women and 74 yrs. for men)

Research and population trends are showing that in the next five years one out of every five people will be over 65 years of age. This includes traumatic brain injury survivors (over 2% of the US population) who are slowly entering the older age population. Will the normal effects of aging worsen the effects of mild to severe brain injury? Will the effects of aging, such as changes in susceptibility to stress, disease and
cognitive impairments, worsen the existing losses from a brain injury?

Possible Complications of Aging
- Decreased speed in cognitive processing, sensory perception
- Susceptible to physical diseases, trauma, stress
- Neuronal death, brain chemical changes
- Reduced speed, reflexes, STM
- Dementia- a pattern of mental decline that can be caused by a number of different disorders or conditions. Alzheimer's Disease causes about 40-45% of dementia

Why Worry about Dementia?
- Increased mortality rates
- Worsened quality of life
- Billions of dollars in health care costs- excluding family and home care costs

Research on Early Onset of Alzheimer's and TBI is limited but may give us a hint as to what to look for in the future
- Mayo Clinic Study found 8-10 year earlier onset of AD
- Mirage Study, apolipoprotein links
- Many studies disputed the early onset of dementia- Rotterdam Study, EURODEM, and others
- So far research available has not shown a consensus of what we should be considering for the future of individuals with a brain injury who are getting older

Long Term Care Issues
- Family changes, social and emotional needs
- Physical, cognitive and psychological changes
- Recreational changes
- Intellectual, vocational changes
- Improve independence and minimize disability level
- Cost effective quality care

What is Needed to Help Survivors of Brain Injury
- The long-term consequences of brain injury (including aging) should be studied
- Research funding for brain injury needs to be increased
- Persons with TBI should have access to rehabilitation services through the entire course of recovery and aging
- Specialized treatment programs are necessary to deal with the particular medical, rehabilitation, family and social needs of persons older than age 65 with TBI
- Educational programs are needed to increase community awareness
- Studies are needed to evaluate the benefits of different brain injury and aging treatments and rehabilitation
- Support for the families and others who provide care for TBI survivors

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