Injured older adults face significant long-term physical and mental health decline, affecting surgical decisions and postoperative support.

• After major injuries, patients needed 1.1 more assistance with daily activities (p < .001).
• They had 70% higher odds of reporting poor health (OR 1.7) and increased depression (OR 1.5).

Surgical teams should assess preinjury social health needs to optimize recovery strategies.

• Injured patients with pre-existing unmet social needs saw a 3.8 increase in outpatient visits and greater cognitive impairment odds (OR 1.4).