#4-94. Precision Diagnostics: Plasma Biomarkers for Geriatric mTBI (JAMANetwOpen, 2026)

Are you frequently challenged by diagnosing mild traumatic brain injury (mTBI) in older adults, where typical head injury symptoms often overlap with pre-existing age-related neurological changes? This study evaluates the diagnostic accuracy of four plasma biomarkers, particularly focusing on glial fibrillary acidic protein (GFAP), in patients aged 60 and older presenting within 72 hours of a suspected head injury. The most critical finding demonstrates that applying personalized diagnostic thresholds—specifically adjusted for an individual's age and biological sex—allows for the objective detection of mTBI, even in clinically ambiguous suspected cases lacking definitive signs. While this personalized biomarker approach is highly promising, critical appraisal reveals notable limitations; this is a single-center, small-scale cross-sectional study, with the suspected mTBI cohort containing only nine individuals, which necessitates further multicenter validation before widespread generalization. Nevertheless, this research is of paramount importance for emergency physicians and clinicians; implementing these tailored blood-based biomarkers can directly enhance triage precision, minimize diagnostic uncertainty, and optimize acute management strategies for older patients presenting with vague head trauma.

Citation: Spitz G, et al. Diagnostic Accuracy of Plasma Biomarkers for Mild Traumatic Brain Injury in Older Adults. JAMA Network Open. 2026. DOI: 10.1001/jamanetworkopen.2026.15678

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