Blood samples uncover concussion in older adults, offering more objective diagnosis

Researchers at Monash University and The Alfred are pioneering a method of analyzing blood samples to diagnose concussion in people aged over 60, the world’s most at-risk group for the condition. Concussion, or mild traumatic brain injury (mTBI), is a significant and escalating public health problem, and older adults experience the highest rates related to hospitalizations and deaths.

Diagnosis and subsequent treatment has always been complicated by difficulty with patients themselves being able to identify and communicate how the injury occurred.

Common concussion symptoms, including memory issues, concentration and fatigue, are also the same as those that present naturally as people age.

Blood biomarker offers clearer concussion clues

The new research, published in JAMA Open Network, found the glial fibrillary acidic protein (GFAP) in a person’s plasma can help indicate whether concussion occurred.

The study of 89 Alfred patients aged 60 to 84 years found levels of the protein were elevated in those who were known to have suffered a concussion compared with those who had not.

Lead author Gershon Spitz, from the Monash School of Psychological Sciences, said implementing the blood test in clinical settings to assist with concussion diagnosis in older adults could significantly improve health outcomes.

“There is a lot of ambiguity in the way the diagnostic process works currently, and doctors often rely on information reported by patients themselves, which comes with all sorts of bias,” Dr. Spitz said.

“When we’re talking about a potential head injury, there are also potentially cognitive issues like loss of consciousness or memory loss, that often makes it difficult for the person to remember clearly what happened in a way that can assist in a diagnosis.

“But the GFAP protein is an objective and reliable measure that we are confident will be a game-changer.”

Potential to transform emergency care

The analysis of biomarkers like plasma have been used in the detection of injuries like concussion in younger populations. This is the first time researchers have proven its usefulness for older adults.

Senior author Professor Sandy Shultz, from the Monash School of Translational Medicine, said it could be a versatile method that could one day be used in a variety of care settings.

“This test could eventually be useful not just to doctors and nurses in a hospital or clinic but first responders like paramedics,” Professor Shultz said.

“Timing is critical for the effective treatment of concussion, particularly in this vulnerable population that often has comorbid conditions that make it even more difficult to diagnose and treat.

“A quick and efficient diagnosis is key to facilitating healthy aging and longevity.”

Real-world trial in trauma patients

Chief Investigator and Alfred Emergency Physician, Professor Biswadev Mitra, trialed the use of the blood tests at The Alfred’s Emergency and Trauma Center.

Consent was sought for patients aged over 65 years who presented to The Alfred from a fall or head injury to provide blood samples, which were analyzed and used as part of a series of screening tools for concussion.

“Within our catchment, falls are the most common type of trauma presentation for patients of this age group, more so than car crashes,” Professor Mitra said.

“When screening for concussion, all patients are monitored for symptoms and many undergo a brain scan to rule out the most serious head injuries.

“However, patients may still have marked concussive injuries that aren’t detected.

“For an older patient cohort at risk of falls, the ability to test and detect for concussion while they are still with us in the emergency department is an invaluable addition to our toolkit as clinicians, enabling us to mitigate risk of subsequent falls and improve patient outcomes.”

Who’s behind this story?

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Sadie Harley

BSc Life Sciences & Ecology. Microbiology lab background with pharmaceutical news experience in oil, gas, and renewable industries.

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Robert Egan

Bachelor’s in mathematical biology, Master’s in creative writing. Well-traveled with unique perspectives on science and language.

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