Factors associated with long-term functional and psychological outcomes in persons with moderate to severe traumatic brain injury.

Abstract

To examine factors impacting long-term functional and psychological outcomes in persons with moderate-severe traumatic brain injury. 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. 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%). 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.