Fall-related traumatic brain injuries in older adults: The role of the neck

Upward of 80% of traumatic brain injuries result from a fall when the head impacts on the ground or other surface in older adults (> 65years of age). Commonly reported risk factors for fall-related traumatic brain injury include older age, female gender, polypharmacy, and impairments of cognition and vision, all of which are difficult to modify. Recent studies have suggested that potentially modifiable factors such as neck strength and range of motion, as well as activation of neck muscles in response to a sudden perturbation, may also be implicated in the etiology of fall-related traumatic brain injuries in older adults. Particularly, the progressive age-related deterioration of neck muscles’ function may compromise the ability to support the head during a fall and result in higher head acceleration which increases the risk of traumatic brain injury. Potential preventive and rehabilitative approaches which involve strengthening of the neck muscles, increasing range of motion, and teaching safe-falling techniques are discussed.