Postconcussion Symptoms After an Uncomplicated Mild Traumatic Brain Injury in Older Adults: Frequency, Risk Factors, and Impact on Quality of Life

Abstract

Background: Postconcussion symptoms (PCSs) are common complaints reported by patients after a mild traumatic brain injury (TBI), and these symptoms may lower quality of life. Previous investigations have primarily focused on PCSs in children, adults, and athletes. The frequency, and risk factors, and effects of PCSs for older adults with mild TBIs are unclear. Purpose: To investigate the frequency and risk factors of PCSs, and investigate their effects on quality of life over time after mild TBI in older adults. Methods: A prospective longitudinal study was performed. All participants were enrolled from the emergency department or neurosurgical outpatient clinics of a medical center. The measurement tools were the Rivermead Post-Concussion Symptoms Questionnaire and the Quality of Life after Traumatic Brain Injury. Measurements were performed on the seventh day, at the first month, and at the sixth month after the head injury. A generalized estimating equation model was used for data analyses. Results: One hundred and one older adults (mean age of 76.0 years) with mild TBIs with negative neuroimaging findings were included. Overall, 32.7%, 4%, and 15.8% of the sample reported PCS after 7 days, 1 month, and 6 months of head injury, respectively, revealing a U-shaped trend. We observed that comorbidity measured using the modified Charlson Comorbidity Index was associated with differences in PCSs (P < .05). PCSs were an independent predictor of changes in postinjury quality of life (P < .001). Conclusions: The results indicate that PCS after a mild TBI in older adults is prevalent, even in the chronic phase after a TBI, and PCSs significantly affected the quality of life of our cohort. Therefore, to improve patient quality of life, healthcare providers should employ effective interventions to manage PCSs at different phases after a TBI.

Good Health-Related Quality of Life in Older Patients One Year after mTBI despite Incomplete Recovery: An Indication of the Disability Paradox?

“…Fourth, since this study was part of the UPFRONT study, a separate sample size calculation was not conducted for the HRQoL questionnaire and its subdomains. However, when considering other studies examining older adults and HRQoL, our group is comparable or even larger [38,54,55]. Therefore, we believe that our sample size was sufficient to provide a reliable assessment of HRQoL, although we might have lacked power for detecting differences at the subdomain level.…”

Management of traumatic brain injury in adult—A cross‐sectional national study

“…29,30 One study indicated that PCS may decrease quality of life, especially in the elderly; frequently reported symptoms over time were dizziness, sleep disturbances, fatigue, and forgetfulness. 31 The strengths of the study include the high response rate and overall completeness of data. A potential weakness may be that many of the respondents are ED doctors and may lack complete knowledge regarding observation routines and follow-up.…”

“…As only a subset of patients have issues with postconcussion syndrome (PCS), predictive scores may be useful to identify which patients may benefit from a structured follow‐up 29,30 . One study indicated that PCS may decrease quality of life, especially in the elderly; frequently reported symptoms over time were dizziness, sleep disturbances, fatigue, and forgetfulness 31 …”

“… 29 , 30 One study indicated that PCS may decrease quality of life, especially in the elderly; frequently reported symptoms over time were dizziness, sleep disturbances, fatigue, and forgetfulness. 31 …”

Correlation of a Graded Step-Test Protocol to the Buffalo Concussion Treadmill Test in Healthy Population

“…Emotional symptoms can include depression, frustration, or restlessness. 4 A study investigating 2-week and 6-month recovery outcomes based on the Glasgow Outcome Scale-Extended Score showed that 73% of respondents demonstrated incomplete recovery at 2 weeks and 56% of respondents demonstrated incomplete recovery at 6 months.…”