M J Rapoport1, A Feinstein. 1. Department of Psychiatry, University of Toronto, Sunnybrook and Women's Health Sciences Centre, Toronto, Ontario, Canada. mark.rapoport@swchsc.on.ca
Abstract
HYPOTHESIS: There will be acute harbingers of poor outcome following mild traumatic brain injury (TBI) in the elderly. PARTICIPANTS: Twenty-six subjects age 60 and over were compared to 30 subjects aged 18-59, seen within 1 month, on average, following a mild TBI. MAIN OUTCOME MEASURES: Functioning was assessed using the Glasgow Outcome Scale (GOS), a global measure of outcome, as well as self-report measures of psychosocial functioning, physical symptoms and psychological distress. RESULTS: Contrary to the hypothesis, the older group did better than their younger counterparts on the GOS (p = 0.002), and reported less psychosocial impairment (p < 0.0001), less psychological distress (p = 0.002), and less physical symptoms (p = 0.005). However, once employment was controlled for, these results only approached statistical significance. DISCUSSION: The assumption that elderly subjects have a worse outcome following TBI needs to be reconsidered, at least within the acute recovery period. The importance of psychosocial factors as modifiers of outcome according to age are emphasized. Whether this finding holds true over a longer follow-up period is the subject of ongoing research.
HYPOTHESIS: There will be acute harbingers of poor outcome following mild traumatic brain injury (TBI) in the elderly. PARTICIPANTS: Twenty-six subjects age 60 and over were compared to 30 subjects aged 18-59, seen within 1 month, on average, following a mild TBI. MAIN OUTCOME MEASURES: Functioning was assessed using the Glasgow Outcome Scale (GOS), a global measure of outcome, as well as self-report measures of psychosocial functioning, physical symptoms and psychological distress. RESULTS: Contrary to the hypothesis, the older group did better than their younger counterparts on the GOS (p = 0.002), and reported less psychosocial impairment (p < 0.0001), less psychological distress (p = 0.002), and less physical symptoms (p = 0.005). However, once employment was controlled for, these results only approached statistical significance. DISCUSSION: The assumption that elderly subjects have a worse outcome following TBI needs to be reconsidered, at least within the acute recovery period. The importance of psychosocial factors as modifiers of outcome according to age are emphasized. Whether this finding holds true over a longer follow-up period is the subject of ongoing research.
Authors: John K Yue; Harvey S Levin; Catherine G Suen; Molly Rose Morrissey; Sarah J Runyon; Ethan A Winkler; Ross C Puffer; Hansen Deng; Caitlin K Robinson; Jonathan W Rick; Ryan R L Phelps; Sourabh Sharma; Sabrina R Taylor; Mary J Vassar; Maryse C Cnossen; Hester F Lingsma; Raquel C Gardner; Nancy R Temkin; Jason Barber; Sureyya S Dikmen; Esther L Yuh; Pratik Mukherjee; Murray B Stein; Tene A Cage; Alex B Valadka; David O Okonkwo; Geoffrey T Manley Journal: Neurol Res Date: 2019-04-21 Impact factor: 2.448