Citation

Karr JE, Luoto TM, Gilman IG, Berghem K, Kotilainen AK, Iverson GL. Acta Neurol. Scand. 2019; ePub(ePub): ePub.

Affiliation

Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital and Spaulding Research Institute; and Home Base, A Red Sox Foundation and Massachusetts General Hospital Program, Boston, Massachusetts, USA.

Copyright

(Copyright © 2019, John Wiley and Sons)

DOI

10.1111/ane.13190

PMID

31693184

Abstract

OBJECTIVES: Previous older adult studies have examined outcome from moderate-to-severe traumatic brain injury (TBI), but fewer have focused on the effects of milder brain injuries. This study examined age-related differences in symptom reporting and whether symptoms are differentially related to functional outcome based on age. MATERIALS & METHODS: Patients presenting with a head injury at the Tampere University Hospital emergency department (N=325, aged 18-100) were evaluated at one week post injury on the Modified Rankin Scale and Rivermead Post Concussion Symptoms Questionnaire (RPQ).

RESULTS: A quarter of participants had missing RPQ data, with missingness associated with greater age and strongly associated with preexisting functional impairment, dementia, and/or neurological conditions. Among participants with complete data, participants <65 years-old endorsed headaches, noise/light sensitivity, irritability, and frustration/impatience at a greater frequency than participants ≥65 years-old. However, no differences were found in the number of symptoms endorsed or the total symptom severity score. The correlations between the severity of symptoms and change in function was similar between the two age groups.

CONCLUSIONS: Older adults tended to report fewer symptoms, but symptoms had a roughly equivalent relationship with declines in functioning across age groups. A large percentage of older adults in this study had pre-injury dementia or neurological disease that contributed to missing data on the one-week outcome measures. The results provide insight into the impact of mild spectrum TBI on older adults compared to younger patients.

© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Language: en

Keywords

Aged; Brain Concussion; Closed; Head Injuries; Outcome Assessment (Health Care); Post-Concussion Syndrome