Your Grandparent Fell and Hit Their Head: Why the People Most Likely to Die from Concussions Have No Baseline

Older adults represent the fastest-growing population for traumatic brain injury emergency department visits in the United States, according to the CDC. Falls are the leading cause of TBI in this age group — and the consequences are disproportionately severe. Research published in PMC (Fu et al., 2016) documented that mortality rates for moderate-to-severe TBI in older adults reach approximately 50% at six months. A systematic review published in PMC (2025) examining concussion treatments in older adults noted the critical gap in evidence-based management for this population.

Why older brains are uniquely vulnerable

The biology makes older adults uniquely vulnerable. Age-related brain atrophy — the natural shrinkage of brain tissue with aging — creates more space inside the skull for blood to accumulate before symptoms appear, as described in the Journal of Neurosurgery. This means a subdural hematoma can progress silently, with the patient appearing relatively normal until sudden decompensation. Anticoagulant medications (warfarin, apixaban, rivaroxaban, and others), commonly prescribed for atrial fibrillation and other conditions, dramatically increase bleeding risk. And as noted by the researchers who developed the Abbott blood biomarker test, the GFAP-based rapid test is significantly less accurate in older adults — the exact population where its clinical value would be greatest.

The gap — and the opportunity

Yet baseline testing is marketed almost exclusively to young athletes. Virtually no baseline testing programs exist for older adults, despite their dramatically higher risk and worse outcomes. This represents both a clinical gap and a market opportunity for forward-thinking healthcare organizations.

A cognitive baseline established during healthy aging — documented performance on memory, processing speed, reaction time, and balance tasks — would provide invaluable reference data for emergency clinicians evaluating an older adult after a fall. It would help distinguish between a cognitive change caused by a new brain injury and the patient’s pre-existing cognitive status.

Baselines for everyone at risk

At Headquarters, we believe baseline testing should be available to everyone at risk — not just athletes. We offer cognitive baselines for older adults that establish healthy cognitive function and provide a reference point in case of a fall or head injury. Talk to us about baseline testing for the seniors in your life. For the companion piece on limits of blood biomarkers in this population, see our Abbott i-STAT TBI breakdown.

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