Age and functioning after mild traumatic brain injury: the acute picture.
OBJECTIVE
There will be acute harbingers of poor outcome following mild traumatic brain injury (TBI) in the elderly.


METHODS
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.


METHODS
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.


CONCLUSIONS
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.
Rapoport
M J
MJ
Department of Psychiatry, University of Toronto, Sunnybrook and Women's Health Sciences Centre, Toronto, Ontario, Canada. mark.rapoport@swchsc.on.ca
Feinstein
A
A
D000208:Acute Disease; D000328:Adult; D000367:Age Factors; D001930:Brain Injuries / Q000503:physiopathology* / Q000523:psychology*; D005260:Female; D023261:Glasgow Outcome Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D020127:Recovery of Function; D012917:Social Adjustment; D013315:Stress, Psychological / Q000209:etiology*