Traumatic brain injuries (TBIs) are often portrayed as the result of dramatic, high-speed events — a violent crash, a hard sports collision, a catastrophic workplace fall. But the data paints a more everyday (and more alarming) picture: millions of TBIs occur each year in the United States, and the single most common pathway is not a highway pileup. It’s a fall. This study from Siegfried & Jensen, will explain this a bit more in depth.
Each year, around 2.5 million Americans sustain a traumatic brain injury, an event that can permanently change memory, mood, movement, and independence. While people of all ages are affected, older adults face the most severe consequences. Adults 75 and older represent nearly one-third of all nonfatal TBI hospitalizations (31.6%) and more than a quarter of TBI deaths, underscoring a public health emergency that’s quietly unfolding in homes, stairwells, driveways, and long-term care settings nationwide.
A TBI occurs when a blow, jolt, or penetrating injury disrupts normal brain function. The injury exists on a spectrum, often described in three tiers: mild, moderate, and severe. Mild TBIs — commonly referred to as concussions — make up more than 75% of cases, and many people underestimate them, assuming symptoms will fade quickly. But even a “mild” brain injury can cause lingering headaches, dizziness, sleep disruption, mood changes, and cognitive fog — and repeated concussions can compound harm over time. Moderate TBIs typically involve more serious neurological disruption, including longer loss of consciousness or abnormal imaging. Severe TBIs, which may include penetrating trauma or prolonged unconsciousness, account for the greatest share of long-term disability and financial burden, even if they occur less frequently.
When researchers examine how these injuries happen, the causes are strikingly consistent. Falls account for roughly 28% of TBIs, making them the leading contributor. Motor vehicle crashes are the next major driver (20%), followed by being hit by or colliding with an object (19%). Assaults account for 11%, and another 12% fall into other or unspecified categories. Together, these figures show that traumatic brain injuries don’t stem from a single risk environment — they arise from daily mobility hazards, road safety failures, occupational exposure, and violence.
Yet the reason falls are so central to the TBI conversation is what happens when age intersects with physiology. For older adults, head trauma is rarely caused by a fight or a sports impact. It’s most often caused by a sudden loss of balance — sometimes triggered by reduced muscle strength, changes in vision, medication side effects, dizziness, neurological conditions, or chronic illness. A fall that might be brushed off at age 35 can become life-altering at 75. Even without visible bleeding, the brain can shift inside the skull with enough force to cause swelling or internal bleeding, and symptoms may worsen over hours or days.
The consequences of moderate to severe TBIs extend far beyond the initial emergency-room visit. Long-term outcomes can include problems with concentration, memory, and decision-making; changes in coordination and balance; sensory disruptions affecting vision or hearing; and emotional changes such as irritability, anxiety, or depression. Five years after a moderate or severe TBI, research indicates that more than half of survivors remain moderately or severely disabled, and many face disruptions to employment, independence, and daily functioning. TBIs also increase the risk of later-life neurodegenerative disease, including dementia, meaning a single injury may quietly reshape health trajectories for years.
The economic toll mirrors the human toll. Nonfatal TBIs alone account for tens of billions of dollars in annual healthcare spending, and that figure does not fully capture lost earnings, long-term caregiving, or reduced quality of life. In many cases, the costs cascade: follow-up hospitalizations, rehabilitation, assistive devices, home modifications, and missed work for both survivors and family caregivers.
Because of this, prevention strategies matter — and many are surprisingly straightforward. For older adults, fall prevention can be strengthened through home safety modifications (better lighting, removing trip hazards, securing rugs, and adding handrails), strength and balance training, routine vision checks, and medication reviews that identify dizziness-related side effects. For families and caregivers, the key is treating falls as predictable risks rather than freak accidents.
Traumatic brain injuries are not a niche medical topic. They are a nationwide safety issue, one where a single moment can set off years of consequences. Recognizing the real drivers of TBIs, especially fall-related injuries among seniors, is the first step toward reducing preventable harm.
