Memory Digest

Preventing Head Injuries

Traumatic brain injury is one of 14 modifiable dementia risk factors, and for older adults most head injuries come from falls; practical ways to protect your head at home, on the road and in sports.

Last reviewed: October 2026

A serious blow to the head can do lasting harm to the brain. The 2024 Lancet Commission on dementia lists traumatic brain injury (TBI) as one of 14 modifiable risk factors, estimating it accounts for about 3% of dementia cases worldwide. People who have had a TBI, especially a severe one or several, have a higher risk of dementia later in life. See Traumatic Brain Injury and CTE for more on how head injuries affect the brain.

The encouraging part: many head injuries can be prevented.

Where head injuries come from

• Falls are the leading cause of head injuries in older adults. The National Institute on Aging notes that falls are a major cause of injury in people 65 and older, and that many falls can be prevented.
• Car, bike and motorcycle crashes.
• Sports and recreation, especially contact sports, cycling, skiing and horseback riding.
• Assaults and violence.

Preventing falls

This is the biggest single step for anyone over 60.

Talk to your doctor. Mention any falls, near-falls or dizziness. Ask for a fall-risk check, which may include a balance test, a review of your medicines, and blood pressure checks lying down and standing up.

Review your medicines. Sleeping pills, some anxiety drugs, certain antidepressants, some blood pressure medicines and drugs with "anticholinergic" effects can cause dizziness or unsteadiness. Never stop a medicine on your own, but ask if any could be adjusted. See Medications That Can Affect Memory.

Build strength and balance. Exercise is one of the best fall-prevention tools. Tai chi, balance classes, walking, and leg-strengthening exercises all help. See Exercise and the Brain. A physical therapist can design a safe program.

Check your eyes and feet. Get your vision checked yearly and update glasses (see Vision Loss and Dementia). Be careful with bifocals on stairs. Wear sturdy, low-heeled shoes with non-slip soles, not loose slippers or socks alone.

Make your home safer. The NIA suggests steps like:

• Remove throw rugs, or secure them with non-slip backing.
• Clear clutter and cords from walkways.
• Install grab bars in the bathroom by the toilet and in the shower or tub.
• Use non-slip mats in the tub and shower.
• Put handrails on both sides of stairs.
• Improve lighting, especially on stairs, and use night lights between the bedroom and bathroom.
• Keep things you use often within easy reach so you don't need a step stool.

See Home Safety for more, especially if someone in the home has dementia.

Get up slowly. Sit on the edge of the bed for a moment before standing, especially at night.

Limit alcohol. It affects balance and judgment (see Alcohol and the Brain).

Consider a medical alert device with fall detection if you live alone.

On the road

• Always wear a seat belt, front seat and back.
• Never drive after drinking or when drowsy, or after taking medicines that cause sleepiness.
• Put the phone away while driving.
• Wear a helmet every time you ride a bike, e-bike, scooter or motorcycle. Make sure it fits snugly and replace it after any crash.
• Review driving safety as you age, especially with memory problems (see Driving and Dementia).

Sports and activity

• Wear the right helmet for cycling, skiing, snowboarding, skating, horseback riding and similar activities.
• Take any concussion seriously. Stop playing, get checked, and don't return to sport until cleared. A second injury before the brain has healed can be especially harmful.
• For children and teens in contact sports, learn the signs of concussion and support rules that limit head impacts. Brain health starts early.

What to do after a head injury

Get medical care right away after a blow to the head, especially for older adults and anyone taking blood thinners, if there is:

• Loss of consciousness, even briefly
• Confusion, unusual drowsiness or trouble waking
• Severe or worsening headache
• Repeated vomiting
• Weakness, numbness, trouble walking or slurred speech
• Seizure
• One pupil larger than the other

In older adults, bleeding around the brain can develop slowly over days or weeks after even a minor bump, causing new confusion, headache or unsteadiness. Mention any recent fall to the doctor. Call 911 for severe symptoms.

The bottom line

Protecting your head is protecting your brain. For most older adults, that means preventing falls: stay active, review medicines, check your eyes, and make your home safer. On the road and in sports, seat belts and helmets are simple, proven protection. See Reducing Dementia Risk: The 14 Risk Factors for all 14 risk factors.

This article is for general information and is not a substitute for advice from your own doctor.

Sources

1. Livingston G et al. Dementia prevention, intervention, and care: 2024 report of the Lancet Standing Commission. Lancet, 2024
2. National Institute on Aging: Falls and Fractures in Older Adults: Causes and Prevention

Not medical advice. This article is general information, not a diagnosis or treatment plan for any individual. Talk with a doctor about your situation.

Related articles

• Traumatic Brain Injury and CTE
• Reducing Dementia Risk: The 14 Risk Factors
• Home Safety
• Exercise and the Brain
• Vision Loss and Dementia