# Aging with a Traumatic Brain Injury: Implications for Balance Deficits and Fall Risk

> **NIH VA I21** · VETERANS HEALTH ADMINISTRATION · 2023 · —

## Abstract

Accumulating research indicates that a TBI sustained in early or middle adulthood has the potential to
influence the trajectory of the aging process, both in the context of brain function and whole-body health.
People who consider themselves to be fully recovered and asymptomatic many years following a brain injury
might actually exhibit poorer function than peers who did not experience a head injury. The TBI literature
reveals compelling evidence that TBI can elicit long-term abnormal cascades of neuroendocrine and
neuroinflammatory processes that alter the structural and functional integrity of brain networks. However, there
is little direct evidence to establish whether “normal” age-related neurodegeneration and decline of physical
and cognitive function are made worse by a TBI that occurred many years earlier. By understanding the
chronic effects of “aging with a TBI” we can better identify potential interventions to reduce negative
repercussions across the lifespan. This is an important area of investigation, considering there is a substantial
window of opportunity for Veterans who have experienced a TBI to engage in rehabilitative interventions and
lifestyle modifications that may preserve function as they transition to older age. The overarching hypothesis of
this new line of research is that participants who experienced a moderate TBI in early or middle adulthood (at
least 15 years prior to study enrollment) will have poorer performance on balance and cognitive tests, despite
self-reporting no persistent motor or cognitive impairment from the TBI. We also seek to evaluate the potential
for practice-based learning and improvement of complex balance tasks in this population, in order to gain
experience for conducting future rehabilitation studies. Veterans with prior TBI (TBI+ group) will be compared
to a control group who report no history of TBI (TBI- group). We propose to enroll Veterans who are
transitioning into older age (i.e., age between 50-65 years). This study will focus on balance function because
of its close association with fall risk. Falls and resultant injuries are a major cause of disability in older Veterans
and civilians, which poses a substantial rehabilitation demand and cost to individuals and society. The
significance of balance deficits and falls will only grow in the coming years, as more than 50% of all Veterans
will be 65 years or older by 2050. Further, loss of balance is very common in the acute stage of recovery from
TBI, suggesting damage to neural control pathways/networks that might be susceptible to chronic effects. As
secondary outcomes, we will conduct assessments that are related to balance function (including cognitive and
oculomotor function) and that increase the risk of injuries due to a fall (bone mineral density). The TBI literature
suggests that these secondary outcomes are also susceptible to the chronic effects of a TBI. The first aim of
the study is to determine if TBI+ participants have impair...

## Key facts

- **NIH application ID:** 10702005
- **Project number:** 1I21RX004641-01
- **Recipient organization:** VETERANS HEALTH ADMINISTRATION
- **Principal Investigator:** David J Clark
- **Activity code:** I21 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2023
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2023-07-01 → 2025-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10702005

## Citation

> US National Institutes of Health, RePORTER application 10702005, Aging with a Traumatic Brain Injury: Implications for Balance Deficits and Fall Risk (1I21RX004641-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10702005. Licensed CC0.

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