Gender Differences in Personal and Situational Risk Factors for Traumatic Brain Injury Among Older Adults

Abstract

Objective: To investigate differences between older men and women in Taiwan in personal and situational risk factors for sustaining a traumatic brain injury (TBI) versus soft-tissue injury (STI) due to a fall. Design: Matched case-control study. Participants and Settings: Cases were defined as patients with a primary diagnosis of TBI due to a fall and were identified from those 60 years or older who visited the emergency department (ED) of 3 university-affiliated hospitals in 2015. Matched by the same hospital ED, gender, and time of falling, 3 controls who had no TBI and who had sustained only soft-tissue injury (STI) due to falling were selected for comparison with each case. Personal factors and situational exposures were compared between the control and case groups. In total, 96 cases and 288 controls in men and 72 cases and 216 controls in women participated in this study. Main Measures: Personal factors (sociodemographic and lifestyle factors, medical characteristics, and functional abilities) and situational exposures (location, activities before the fall, center-of-mass change, type of fall, falling direction, protective response, and impact during the fall). Results: In men, after adjusting for other variables, older age (odds ratio [OR] = 1.04), regular alcohol use (OR = 2.03), an indoor fall (OR = 1.92), activity of getting in/out of bed (OR = 2.56), a fall due to dizziness (OR = 4.09), and falling backward (OR = 2.95) were independently associated with a higher odds of TBI. In women, an older age (OR = 1.03), the presence of Parkinson disease (OR = 10.4), activities of toileting (OR = 2.50), getting in/out of bed (OR = 4.90), and negotiating stairs (OR = 7.13), a fall due to dizziness (OR = 5.05), and falling backward (OR = 2.61) were independently associated with a higher odds of TBI. Conclusions: Our results demonstrated similarities and differences in personal and situational risk factors for fall-related TBIs versus STIs between older men and women, and gender differences should be considered when developing intervention strategies.

Sex differences in mortality of older adults with falls after emergency department consultation: FALL‐ER registry

“…Regarding falls, our results show that women presented more bone injuries and needed more immobilizations after falls. This may be the result of a significant reduction in bone mineral density after menopause, but may also be a consequence of declining motor coordination and having less muscle mass and strength than men 23,35 . Furthermore, gender‐related behaviors could contribute to an increase or decrease in the risk of several diseases.…”

“…This may be the result of a significant reduction in bone mineral density after menopause, but may also be a consequence of declining motor coordination and having less muscle mass and strength than men. 23,35 Furthermore, genderrelated behaviors could contribute to an increase or decrease in the risk of several diseases. In this regard, we found that women more frequently lived alone and had self-reported depression.…”

Risk Factors for Traumatic Brain Injury in Men and Women

“…The limitation of a study is the absence of the control group to compare the incidence rate between men and women. The outcomes of post TBI depend on the gender [2,[10][11][12][13][14][15][16][17][18]. Different studies suggested that age plays a central role in increasing the risk of TBI [19].…”

Preventive strategies for feeding intolerance among patients with severe traumatic brain injury: A cross-sectional survey

“…As these scores are the classic assessment methods for STBI patients, they have been widely used in clinical practice. Studies have shown that basic characteristics of patients, such as age and sex, are risk factors for disease severity [ 16 , 17 ]. For example, atrophy of intestinal mucosa can occur in the older people, affecting the absorption and transportation of water and electrolytes [ 18 ].…”