A-03 Preliminary Evidence for Motor Vehicle Accidents and Associated Concussion Response Severity in Older Adults

Abstract

Abstract Purpose To determine if mechanism of injury is associated with differences in initial response to concussion in older adults. Methods Fifty older adults (54% female) aged 50-84 (59.14±6.54) were recruited from a sports medicine concussion clinic at initial appointment. Inclusion criteria included age (50+) and injury date within the last year. Exclusion criteria included prior diagnosis of a neurological disorder and/or brain malformation, psychiatric diagnosis other than anxiety/depression, prior history of moderate or severe brain injury, and/or ongoing litigation. Mechanism of injury in the sample included 22 falls/accidents (44%), 20 MVAs (40%), 2 sport/recreation (4%), 1 assault (2%), and 5 other (10%). Participants were assigned to two independent groups, MVA and Non-MVA. Outcome measures included Vestibular/Ocular-Motor Screening (VOMS), Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT), and Concussion Clinical Profile Screening (CP Screen). Response severity was operationalized by VOMS Total and CP Screen Total. Two-tailed independent t-tests (alpha<.05) examined differences between groups at initial visit. Results There were no significant differences between groups in terms of demographics or other common risk factors. There were no differences between groups for response severity. The MVA group reported more severe vestibular complaints t(41) =2.07, p=.044, more severe cognitive complaints, t(44)=3.68, p<.001, and demonstrated worse scores on domains of visual memory, t(43)=-2.16, p=.037, reaction time, t(43)=3.07, p=.004, and visual motor speed, t(43)=-2.85, p=.007. Conclusions MVA-related concussions may result in more focal disruption of vestibular and cognitive performance in older adults. Future research is warranted to confirm the findings of this study, to explore potential explanations for these findings, and to further explore how concussion presents in older adults.