Project Summary/Abstract Incidence, hospitalization, and mortality for traumatic brain injuries (TBIs) have greatly increased in the past decade, even more so for the expanding geriatric population. Despite this, current diagnostic and prognostic tools for TBI remain wholly inadequate. With this application, we propose to test and optimize the performance of the BRAINBox TBI Test system, which has received Breakthrough Designation from the FDA as a first in kind device providing both diagnosis and prognosis of future symptoms. This test system can rapidly detect multiple highly specific blood biomarkers and test neurocognitive performance in less than 20 minutes. Combining functional and biological evidence of injury, this multimodality test provides the necessary data for an instant readout of brain health. We will train the algorithms that provide the test result to recognize patterns in individual patients that are specific for TBI even in the presence of cognitive decline or dementia. This distinction is critical to effective diagnosis in this patient age group, where brain injuries due to falls or other causes are too often left undiagnosed. This work will adapt a novel, effective testing system to the needs of our growing geriatric population, which will enable rapid mTBI diagnosis and prognosis at the bedside with a single device. Development and validation of this product to address the underdiagnosis of geriatric TBI and help prevent the frequent debilitating outcomes that are clinically elusive due to neurocognitive decline and dementia.