Aging reveals domain-specific vulnerability to the chronic behavioral consequences of repetitive mild traumatic brain injury

Older adults are among the fastest growing groups of traumatic brain injury (TBI) patients and sustain disproportionately poor chronic outcomes. Despite this, the preclinical aging-TBI literature is limited. Beyond the limited presence of aging TBI studies, most studies published in this domain use moderate-to-severe, open head models of TBI, rather than closed head models of mild TBI (mTBI) and repetitive mTBI (rmTBI), the most clinically prevalent presentation. Whether age modulates the chronic behavioral consequences of rmTBI is unknown. In the current study, young (3-4 months) and aged (18-19 months) male C57BL/6 mice received either five mTBIs on alternating days to model rmTBI or sham procedures and underwent behavioral testing in the chronic phase for spatial memory and anxiety-related behavior. Because cross-age behavioral comparisons are confounded by age-related declines in activity and by large sample sizes necessary to detection interaction effects, we applied a three-tier analytical framework combining within-age comparisons, sham-normalized inter-age comparisons, and factorial two-way ANOVA. Contrary to our hypothesis that aging would worsen rmTBI behavioral deficits, age produced domain-divergent effects. Spatial memory deficits were directionally consistent in both young and aged mice but was attenuated in the aged group. Conversely, anxiety-related behavior emerged selectively in the aged mice showing increased thigmotaxis. Locomotion was driven by age alone, with no injury effect, confirming that the aged anxiety signal was not a locomotor artifact. A post-hoc sensitivity analysis indicated that resolving the Age x Injury interaction effect would require at least 44 animals per group. These findings show that age shapes the affective, but not the cognitive, consequences of chronic rmTBI, and underscoring that statistical strategy is inseparable from design in factorial injury studies.