Wednesday, 4 January 2012

Molly Meldrum and TBI in the elderly

Ian Molly Meldrum On 15 December 65 year-old Ian “Molly” Meldrum fell 3 metres downstairs whilst putting up Christmas decorations in his home, striking his head and fracturing his skull. He was hospitalised, sedated and placed on a ventilator to help him breathe.

From the little information released by the media on his condition and recovery since the fall it appears that:
  • Molly was unconscious for several days and possibly more than a week – although it is understood that he was in an induced coma for part of that time
  • He regained consciousness after Christmas but remains disoriented and confused
  • He is only able to respond to basic commands and is unable to carry on a conversation
  • He can recognise close family members at times but this is inconsistent
These factors suggest that Molly sustained a traumatic brain injury (TBI) that was at least in the severe and possibly extremely severe, range.

Today’s ABC news report predicts that Molly has “a very, very long haul ahead of him”.

Research supports this assertion. Older age is an important predictor of worse outcome after TBI, even with relatively minor head injuries. A study by Mosenthal and colleagues (2002) found that elderly patients had twice the in-hospital mortality of younger TBI patients, the mortality rate increasing for each decade over 50 years. Elderly survivors of TBI are more likely to have a severe disability or be in a persistent vegetative state. The incidence of complications and poorer outcome after surgery are also worse for older patients.

The best predictors of a favourable outcome following TBI are younger age and lesser severity of TBI.
While this doesn't bode well for Molly, he does appear to be making some progress and all signs are that his functioning will continue to improve. It is also likely that he is getting the best possible care, which can make all the difference in ensuring the best possible recovery.

The thoughts of the ANTS team are with Molly and his family and we wish him a speedy recovery.

If you would like more information about TBI, cognitive rehabiliation or other ANTS services, please contact us.

Mosenthal, A.C., Lavery, R.F., Addis, M., et al. (2002). Isolated traumatic brain injury: Age is an independent predictor of mortality and early outcome. Journal of Trauma, 52(5), 907-911.,8

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