TOPLINE:

After a moderate-to-severe traumatic injury, older adults with dementia had a higher likelihood of experiencing new limitations to activities of daily living than those without dementia. Older women with dementia were more likely to move from home to long-term care facilities post-injury.

METHODOLOGY:

• Researchers conducted an analysis using data from hospital registries of three level I trauma centers in Boston, involving 3210 older adults with moderate-to-severe trauma (mean age, 78.6 years; 59.3% women) from a prospective cohort study.
• The study compared outcomes between 291 patients with dementia and 2919 without dementia, focusing on functional decline.
• Trained assistants conducted interviews via telephone with patients or their caregivers 6-12 months post-injury (2015-2024), assessing patients’ abilities and limitations in performing activities of daily living across eight domains, including walking, dressing, and eating, using the PROMIS Physical Functioning instrument.
• Respondents reported their ability to perform activities without assistance pre-injury, with a composite score indicating the number of new limitations post-injury.
• Loss of community living was also assessed and defined as moving from a private residence to a long-term care facility after the injury.

TAKEAWAY:

• Patients with dementia were more likely to experience falls as the mode of injury than those without dementia (96.9% vs 86.1%; P < .001).
• The severity of injury was similar between patients with and without dementia; however, patients with dementia had higher rates of surgical complications during their hospital stay (P < .001).
• Patients with dementia were more likely to report new difficulties in function post-injury (odds ratio [OR], 1.62; P < .001) and to lose community living status (OR, 2.30; P < .001).
• Older women with dementia had significantly higher odds of losing community living status than those without dementia (OR, 2.12; 95% CI, 1.17-3.84; P = .013).

IN PRACTICE:

“For older adults with dementia, traumatic injury represents a pivotal turning point where postacute care programs may buffer an otherwise steep trajectory of functional decline. As trauma systems increasingly serve aging patient populations impacted by cognitive impairment, targeted interventions aimed at preserving function and supporting patients with the resources required for independent living will be essential for improving outcomes after injury,” the authors wrote.

SOURCE:

The study was led by Joshua E. Cohen of the Center for Surgery and Public Health at the Brigham and Women’s Hospital in Boston. It was published online on December 14, 2025, in the Journal of the American Geriatrics Society.

LIMITATIONS:

The study’s findings may not be generalizable to populations outside the Boston area. Potential selection bias may exist due to reliance on follow-up interviews, which could exclude patients with severe cognitive impairments. Differences in self-reporting vs caregiver reporting may introduce bias in assessing independence in activities of daily living.

DISCLOSURES:

The authors did not report receiving any specific funding. No relevant conflicts of interest were disclosed by the authors.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.