What People with — and without — TBI Should Know as They Age
Dr. Jordan Grafman discusses the research around aging with a TBI — from the importance of regular social interaction to the strategies for reducing tissue damage as the brain ages.
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We know that there's an increased risk of traumatic brain injury in older people, and that's partly because we're living longer lives, and we want to stay in our homes, and we're not accommodating our home environments to the increased risk of, for example, falls. So, besides keeping a clean house, do we need aids to get in and out of a bathtub, for example, something to hold on to. These kinds of things are critical--can help prevent traumatic brain injury. But once you've had the brain injury, there are probably 2 key areas that are very important for health care workers to focus on. One is how do you treat as early as possible the improper cascades that occur in the brain that damage nervous system tissue. Now, they're not going to change the brain so that it looks the same after a traumatic brain injury, but they're going to try to reduce the amount of tissue damage that occurs as early as possible. So, that's 1 area that's receiving a lot of attention. The other area has to do with sculpting neuroplasticity. Are there drugs, for example, that can aid in the reorganization of neural networks that enable a better recovery, and what about the rehabilitation treatment that you get--the strategies, the training you receive-- how does that work, and does that enable you to improve neuroplastic functions after a brain injury? It's the combination of all these efforts that people are working on now, and we know that sometimes it could be something as trivial in improving outcome as improving the interactions between a caregiver and a person. There are old studies that are valid with rats that show after you give a rat a brain injury and you put it back in the cage, it'll recover a bit. You put it back in a cage that has a treadmill, that rat does better. You throw that rat back in a cage with another rat, that rat does the best. So, simply the addition of a social milieu improves outcome for a variety of reasons, but it may be as effective and a lot cheaper to train a caregiver to learn how to interact better with the patient and to protect their own health, which is important as well if they're caregiving for somebody. It's hard to change the biology of the brain completely in trying to treat traumatic brain injury, so what you want to do is help the people as best they can recover by optimizing neuroplastic changes, and that's often going to involve decisions. It may involve decisions.
Posted on BrainLine February 11, 2013.
Jordan Grafman, PhD, is director of Brain Injury Research, Rehabilitation Institute of Chicago. His investigation of brain function and behavior contributes to advances in medicine, rehabilitation, and psychology, and informs ethics, law, philosophy, and health policy.
Produced by Victoria Tilney McDonough, Justin Rhodes, and Erica Queen, BrainLine.