title: Factors associated with long-term functional and psychological outcomes in persons with moderate to severe traumatic brain injury.
abstract: OBJECTIVE
  To examine factors impacting long-term functional and psychological outcomes in persons with moderate-severe traumatic brain injury.
  
  
  METHODS
  A prospective cross-sectional study (n = 103) assessed the long-term (up to 5 years) impact of traumatic brain injury on participants' current activity and restriction in participation using validated questionnaires.
  
  
  RESULTS
  Participants' median age was 49.5 years (interquartile range (IQR) 20.4-23.8), the majority were male (77%), and 49% had some form of previous rehabilitation. The common causes of traumatic brain injury were falls (42%) and motor vehicle accidents (27%). Traumatic brain injury-related symptoms were: pain/headache (47%), dizziness (36%), bladder/bowel impairment (34%), and sensory-perceptual deficits (34%). Participants reported minimal change in their physical function and cognition (Functional Assessment Measure: motor (median 102, IQR 93-111) and cognition (median 89, IQR 78-95)). Participants were well-adjusted to community-living; however, they reported high levels of depression. Factors significantly associated with poorer current level of functioning/well-being included: older age (≥ 60 years), presence of traumatic brain injury-related symptoms, a lack of previous rehabilitation and those classified in "severe disability categories" at admission. Caregivers reported high levels of strain and burden (55%).
  
  
  CONCLUSIONS
  Cognitive and psychosocial problems are more commonly reported than physical disability in the longer-term. A greater focus on participation and ageing with disability in these persons is needed.
authors.affiliation: Department of Rehabilitation Medicine, Royal Melbourne Hospital, 34-54 Poplar Road, Parkville, Melbourne VIC 3052, Australia. fary.khan@mh.org.au.
authors.forename: Fary
authors.initials: F
authors.lastname: Khan
authors.forename: Bhasker
authors.initials: B
authors.lastname: Amatya
authors.forename: Rodney
authors.initials: R
authors.lastname: Judson
authors.forename: Pearl
authors.initials: P
authors.lastname: Chung
authors.forename: Melinda
authors.initials: M
authors.lastname: Truesdale
authors.forename: Alaeldin
authors.initials: A
authors.lastname: Elmalik
authors.forename: Mary P
authors.initials: MP
authors.lastname: Galea
mesh_terms: D000063:Accidents, Traffic; D000328:Adult; D000368:Aged; D000070642:Brain Injuries, Traumatic / Q000150:complications / Q000523:psychology* / Q000534:rehabilitation*; D003072:Cognition Disorders / Q000209:etiology; D062309:Community Integration; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods; D010146:Pain / Q000209:etiology; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D055815:Young Adult