Aging effect on psychosocial outcome in traumatic brain injury.
OBJECTIVE
To examine the effects of age on outcome in persons with traumatic brain injury.


METHODS
Longitudinal cohort design.


METHODS
Level I trauma center.


METHODS
A total of 411 hospitalized subjects with mild to severe traumatic brain injury prospectively studied to 1 year; their age range was 18 to 89 years.


METHODS
Glasgow Outcome Scale, living situation, and employment.


RESULTS
Increasing age is associated with increasing levels of psychosocial limitations, especially in persons 60 years of age and older. Part of the reason is the greater severity of injury sustained by older persons as reflected in longer coma (despite equivalent initial coma depth) and greater numbers of complications and surgeries for subdural hematomas. However, the consequences of traumatic brain injuries appear to worsen with increasing age at each level of brain injury severity examined, including the milder injuries.


CONCLUSIONS
Older adults clearly show less complete recovery 1 year after brain injury than younger adults, either because they have reduced reserves with which to tolerate brain injury or because their physiologic status creates a more destructive injury. Glasgow Coma Scale alone may underestimate the severity of brain injury in the aged as well as its associated consequences. Caution is advised in generalizing findings based principally on younger individuals to older adults with traumatic brain injuries.
Department of Rehabilitation Medicine, University of Washington, Seattle 98195-6490, USA.
B
B
Rothweiler
N R
NR
Temkin
S S
SS
Dikmen
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology / Q000523:psychology; D001930:Brain Injuries / Q000150:complications / Q000503:physiopathology* / Q000523:psychology* / Q000534:rehabilitation; D004651:Employment; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016896:Treatment Outcome