Outcome after traumatic brain injury: effects of aging on recovery.
OBJECTIVE
To identify differences in outcome after traumatic brain injury (TBI) compared with orthopedic injuries as a function of age.


METHODS
Longitudinal data analyses from an inception cohort.


METHODS
Outpatient rehabilitation program.


METHODS
Eighty-two orthopedic injury patients and 195 TBI patients.


METHODS
Not applicable.


METHODS
Independent living, employment, and level of functioning 1 to 2 years after injury.


RESULTS
Older patients and those with TBI were more likely to have increased dependence postinjury. Older TBI patients were more likely to have changes in employment status compared with orthopedic injury patients younger or TBI. The Mayo-Portland Adaptability Inventory and Disability Rating Scale were moderately predictive of level of functioning, return to employment, and independent living status 1 to 2 years postinjury. Injury severity was only mildly predictive of outcome.


CONCLUSIONS
The effect of age on outcome affects recovery from neurologic injuries and, to a lesser extent, orthopedic injuries. Outcome after TBI is best predicted by patients' age and estimates of level of function at discharge. Findings suggest that older patients and those with TBI have a greater likelihood of becoming physically and financially dependent on others. Rehabilitation efforts should focus on maximizing levels of independence to limit financial and emotional costs to patients and their families.
Testa
Julie A
JA
Department of Psychiatry, Mayo Clinic, Rochester, MN 55905, USA.
Malec
James F
JF
Moessner
Anne M
AM
Brown
Allen W
AW
D000203:Activities of Daily Living; D000222:Adaptation, Physiological; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000375:Aging / Q000502:physiology*; D000553:Ambulatory Care; D000704:Analysis of Variance; D001930:Brain Injuries / Q000175:diagnosis / Q000534:rehabilitation*; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D011237:Predictive Value of Tests; D011336:Probability; D011379:Prognosis; D011788:Quality of Life; D020127:Recovery of Function; D018570:Risk Assessment; D018434:Sickness Impact Profile; D016896:Treatment Outcome