A simple blood test could revolutionize how emergency doctors diagnose concussion in people over 60, the group most vulnerable to the injury and its complications. Researchers at Monash University and The Alfred in Melbourne have discovered that a protein called GFAP, measured in blood plasma, can objectively identify whether an older adult has suffered a concussion—removing the guesswork that has long complicated diagnosis and treatment.
Concussion, or mild traumatic brain injury, is a growing public health problem for aging populations. Older adults experience the highest rates of concussion-related hospitalizations and deaths, yet paradoxically, they are also the hardest to diagnose. The challenge is profound: the common symptoms of concussion—memory problems, concentration difficulties, and fatigue—overlap almost entirely with the natural cognitive changes of aging. On top of that, patients who have suffered head injuries often cannot clearly recall or communicate how the injury happened, leaving doctors to piece together a diagnosis from incomplete information and subjective accounts.
The new research, published in JAMA Open Network, studied 89 patients aged 60 to 84 years at The Alfred's Emergency and Trauma Center. The study found that levels of GFAP protein were significantly elevated in patients known to have suffered a concussion compared to those who had not. This objective marker offers what clinicians have long needed: a reliable, measurable way to confirm concussion independent of patient memory or symptom reporting.
"There is a lot of ambiguity in the way the diagnostic process works currently, and doctors often rely on information reported by patients themselves, which comes with all sorts of bias," explained Gershon Spitz, lead author and researcher from the Monash School of Psychological Sciences. "But the GFAP protein is an objective and reliable measure that we are confident will be a game-changer." While blood biomarkers have been used to detect concussion in younger populations, this is the first time researchers have proven the method works for older adults—a population where the stakes are particularly high.
The practical implications are significant. Professor Biswadev Mitra, an emergency physician at The Alfred who ran the real-world trials, emphasized that speed is critical. Within his catchment, falls are the most common type of trauma presentation for older patients—more frequent than car crashes. When a fall-related head injury occurs, quick and accurate diagnosis can prevent subsequent falls and serious complications. "For an older patient cohort at risk of falls, the ability to test and detect for concussion while they are still with us in the emergency department is an invaluable addition to our toolkit as clinicians," Mitra said.
Professor Sandy Shultz from the Monash School of Translational Medicine envisions an even broader application. The blood test could eventually be deployed not just in hospitals and clinics, but by first responders like paramedics, enabling diagnosis at the moment of injury. "Timing is critical for the effective treatment of concussion, particularly in this vulnerable population that often has comorbid conditions that make it even more difficult to diagnose and treat," Shultz noted. For older adults navigating a complex health landscape, a simple blood test that confirms what happened in those crucial first moments after a fall could be the difference between recovery and decline.