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Prognostic Markers for Poor Recovery After Mild Traumatic Brain Injury in Older Adults: A Pilot Cohort Study
Vicki L Kristman1, Robert J Brison, Michel Bédard
1Department of Health Sciences, Lakehead University, Thunder Bay, Ontario, Canada (Drs Kristman and Bédard and Ms Reguly); Division of Human Sciences, Northern Ontario School of Medicine, Lakehead University, Thunder Bay, Ontario, Canada (Drs Kristman and Bédard); Centre for Education and Research on Aging & Health, Lakehead University, Thunder Bay, Ontario, Canada (Drs Kristman and Bédard); Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada (Dr Kristman); Department of Emergency Medicine, Queen's University, Kingston General Hospital, Kingston, Ontario, Canada (Dr Brison); St. Joseph's Care Group, Thunder Bay, Ontario, Canada (Dr Bédard); and Thunder Bay Regional Health Sciences Centre, Thunder Bay, Ontario, Canada (Ms Chisholm).
Objective:
To identify prognostic markers associated with poor recovery from mild traumatic brain injury (MTBI) in older adults.
Setting:
Three Ontario emergency departments.
Participants:
Forty-nine participants aged 65 years and older that visited an emergency department for MTBI.
Design:
Pilot prospective cohort study.
Main Measures:
Recovery from MTBI determined using the Rivermead Postconcussion symptom Questionnaire, the Glasgow Outcomes Scale-Extended, physical and mental health functioning (SF-12), and a single question on self-rated recovery assessed by telephone shortly after emergency department visit (baseline) and again 6 months later. Predictors were measured at baseline.
Results:
Markers potentially associated with poor recovery included reporting worse health 1 year before the injury, poor expectations for recovery, depression, and fatigue.
Conclusion:
Recovery after MTBI in older adults may be associated more with psychosocial than with biomedical or injury-related factors.
