Impaired cognition in geriatric patients with relation to earlier life mood disorder and traumatic brain injury: a hypothesis

The challenges of the geriatric years require cognitive integrity through organic resilience of the brain. Impaired cognition in geriatric patients (age >65 years) is commonly ascribed to age but is multifactorial. Among those multiple factors this author hypothesizes that mood disorders, with major depressive disorder (MDD) as one focus of this paper and traumatic brain injury (TBI) are part of a common spectrum of pathology that, when undiagnosed and untreated at age <65 years, reduces the resilience of the brain to negotiate common challenges during geriatric years. Mood disorders and TBI may be acute, transient, and benign; however, chronic mood disorders may be an organic brain disease, as shown by objective studies. The consequence of the ineffective treatment of MDD and TBI at an earlier age may cause geriatric patients to have impaired capacity to manage stressors. The solution may include more astute observation of the presentation to enable earlier diagnosis and treatment. Mitigating the consequences of mood disorders and TBI may enable greater resilience to face the challenges of aging.