The role of mood, post-traumatic stress, post-concussive symptoms and coping on outcome after MTBI in elderly patients

Abdulle, Amaal Eman; Naalt, Joukje van der

doi:10.1080/09540261.2019.1664421

Cited by 11 publications

(12 citation statements)

References 53 publications

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“…The eight adult studies that centered on symptoms of depression utilized the adapted version of the Composite International Diagnostic Interview Screening Scales ( 61 , 88 ), qualitative interviews ( 62 , 81 ), the British Columbia Major Depression Inventory, 2nd Edition ( 63 , 82 ), the Center for Epidemiological Studies Depression Scale ( 64 , 83 ), the Beck Depression Inventory ( 65 , 66 , 68 , 94 ), or the General Health Questionnaire ( 67 , 84 ). Between the nine adult studies on combined symptoms of anxiety and depression, four used the Hospital Anxiety and Depression Scale ( 70 , 72 , 75 , 76 , 93 ), while others used the Impact of Event Scale ( 69 , 95 ), the Rivermead Post-Concussion Symptoms Questionnaire ( 69 , 96 ), Depression and Anxiety Stress Scales-42 ( 71 , 85 ), the Beck Anxiety Inventory ( 73 , 86 ) and Beck Depression Inventory ( 73 , 94 ), interviews with symptoms according to DSM-IV criteria ( 74 , 87 ), and the Glasgow Outcome Scale -Extended ( 77 , 97 ). Finally, the two adult studies that included “other” mental health outcomes, included the Impact of Event Scale ( 69 , 95 ) and qualitative interviews ( 62 , 81 ).…”

Section: Resultsmentioning

confidence: 99%

“…For each of these studies, the severity of both depression and anxiety was measured. There were five studies that reported a higher prevalence of anxiety and depression symptoms in patients who develop PPCS ( 69 , 71 , 72 , 74 , 75 ). Four studies did not find a significant difference in both outcomes ( 69 , 73 , 77 , 98 ).…”

Section: Resultsmentioning

confidence: 99%

“…Children and youth are at a critical period where mental health is impressionable and malleable, justifying the need for more pediatric studies. In addition, only one study focused on geriatric populations ( 72 ), even though falls are a primary cause of concussion, and common in older adults ( 104 , 105 ). Furthermore, older adults report more pre-existing cognitive impairments that make it difficult to treat and manage concussion ( 106 ), as well literature suggests older adults can experience poor quality of life post-concussion, due to factors such as reduced independence and difficulty in recovery due to comorbidities or frailty ( 107 ).…”

Section: Discussionmentioning

confidence: 99%

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Mental Health Outcomes Across the Lifespan in Individuals With Persistent Post-Concussion Symptoms: A Scoping Review

et al. 2022

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Objective:Concussion is a common yet heterogenous injury. Approximately 15–30% of cases present with persistent post-concussion symptoms (PPCS), continuing 4 weeks or more post-injury in children, youth, and adolescents, and 3 months or more in adults. There are known bidirectional links between PPCS and mental health outcomes. The focus of this scoping review is to explore the literature on mental health outcomes in individuals experiencing PPCS. Research objectives were to explore: (1) the mental health outcomes of individuals with PPCS and types of assessments used to identify mental health outcomes this group, and (2) how mental health outcomes compare in terms of similarities and differences among pediatric and adult populations with PPCS.MethodOvid MEDLINE; EMBASE; CINAHL, and PsycInfo databases were searched. After title and abstract screening of 11,920 studies, 481 articles were reviewed. Twenty-five papers met inclusion criteria. Results were organized by mental health outcomes of pediatric and adult populations, separately.ResultsThere was a significantly higher number of studies devoted to adult populations. Of the 25 studies, 19 (76%) focused on adults, while six (24%) focused on adolescents. In adult populations, studies focused on symptoms of: anxiety (n = 2), depression (n = 8), and anxiety and depression (n = 9). Two studies assessed other emotional outcomes (10.5%). Within pediatric populations, an equal number of studies explored symptoms of: anxiety (n = 2), depression (n = 2), and anxiety and depression (n = 2). No studies focused on other emotional outcomes. Studies ranged greatly in methods, design, and control group. Most studies reported higher psychiatric symptoms of anxiety and/or depression in those with PPCS compared to individuals with recovered concussion or healthy controls.DiscussionThis review contributes to the understanding of mental health outcomes in those experiencing PPCS. Mental health and PPCS requires greater attention in pediatric populations, and consider strategies for those experiencing PPCS and mental health impacts. Future studies should consider including a wider range of emotional outcomes in their design, not limited to anxiety and depression. Study results may lead to improvements and research in the identification, assessment, and management of PPCS and mental health.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Mental Health Outcomes Across the Lifespan in Individuals With Persistent Post-Concussion Symptoms: A Scoping Review

et al. 2022

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“…PCS for this same sample was also examined (Abdulle et al, 2020) using the Head Injury Symptoms Checklist (HISC) and measures of posttraumatic stress and coping. Results indicated that 73% of older people endorsed at least one PCS 2 weeks after injury, with the most frequent complaints being dizziness, fatigue, and headache.…”

Section: Hume-mtbi Outcome In Older Peoplementioning

confidence: 99%

“…Five studies reported the proportion of "complete" recovery for older adults using the GOS/GOSE; four examined outcome at 6-month post-injury, whereas one study (Deb et al, 1998) observed outcome at 1-year post-injury. The paper by Abdulle & van der Naalt (2020) was initially identified for inclusion; however, as this study dichotomised older age as ≥60 years and all other studies defined older age as ≥65 years, the van der Naalt et al ( 2017) data, which shared the same sample as Abdulle et al (2018Abdulle et al ( , 2020 and reported proportion of recovery based on age ≥65 years, was used in preference. This also provided data for a further subgroup analysis (old vs. young), as two other studies reported proportion of recovery for younger adults aged between 18 and 64 years as well as their older age samples.…”

Section: Life Participationmentioning

confidence: 99%

Systematic Review and Meta-analysis of Outcome after Mild Traumatic Brain Injury in Older People

Hume

Wright

Kinsella

2021

J Int Neuropsychol Soc

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Objective: Older age is often identified as a risk factor for poor outcome from traumatic brain injury (TBI). However, this relates predominantly to mortality following moderate–severe TBI. It remains unclear whether increasing age exerts risk on the expected recovery from mild TBI (mTBI). In this systematic review of mTBI in older age (60+ years), a focus was to identify outcome through several domains – cognition, psychological health, and life participation. Methods: Fourteen studies were identified for review, using PRISMA guidelines. Narrative synthesis is provided for all outcomes, from acute to long-term time points, and a meta-analysis was conducted for data investigating life participation. Results: By 3-month follow-up, preliminary findings indicate that older adults continue to experience selective cognitive difficulties, but given the data it is possible these difficulties are due to generalised trauma or preexisting cognitive impairment. In contrast, there is stronger evidence across time points that older adults do not experience elevated levels of psychological distress following injury and endorse fewer psychological symptoms than younger adults. Meta-analysis, based on the Glasgow Outcome Scale at 6 months+ post-injury, indicates that a large proportion (67%; 95% CI 0.569, 0.761) of older adults can achieve good functional recovery, similar to younger adults. Nevertheless, individual studies using alternative life participation measures suggest more mixed rates of recovery. Conclusions: Although our initial review suggests some optimism in recovery from mTBI in older age, there is an urgent need for more investigations in this under-researched but growing demographic. This is critical for ensuring adequate health service provision, if needed.

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Depressive Symptoms in Individuals With Persistent Postconcussion Symptoms: A Systematic Review and Meta-Analysis

et al. 2022

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ImportanceApproximately 15% to 30% of individuals with a history of concussion present with persistent postconcussion symptoms (PPCS). Individuals with PPCS are at greater risk of experiencing depressive symptoms.ObjectiveTo synthesize the association between depressive symptoms and PPCS in children, adolescents, and adults via meta-analysis and to investigate potential moderators of that association.Data SourcesSystematic search of Ovid Medline, CINAHL, PsycInfo, and Embase from 1995 to January 2022 was performed. Additionally, references from included studies were hand-searched to ensure relevant articles were captured in the search.Study SelectionStudies that involved participants who experienced PPCS and quantified depressive symptoms were included. The definition of PPCS was limited to physician-diagnosed or self-reported concussion, with symptoms lasting for a minimum of 4 weeks postinjury. Two authors independently screened all articles to determine study eligibility.Data Extraction and SynthesisStudy characteristics were extracted independently by 2 trained investigators. Study data were meta-analyzed using a random-effects meta-analysis.ExposurePPCS.Main Outcomes and MeasuresThe the primary outcome was depressive symptoms.ResultsData were extracted from 18 studies with a total of 9101 participants. Of the 18 studies, all were cohort studies, and 13 (72%) comprised adult populations. The mean (SD) time since concussion was 21.3 (18.7) weeks. After accounting for potential publication bias, the random-effects meta-analysis found a significant positive association between PPCS and depressive symptoms, (odds ratio, 4.56; 95% CI, 2.82-7.37; P &lt; .001). There were no significant moderators, likely due to the small number of studies included.Conclusions and RelevanceIn this meta-analysis, experiencing PPCS was associated with a higher risk of experiencing depressive symptoms. There are several important clinical and health policy implications of the findings. Most notably, the development of strategies for effective prevention and earlier intervention to optimize mental health recovery following a concussion should be supported.

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The role of mood, post-traumatic stress, post-concussive symptoms and coping on outcome after MTBI in elderly patients

Abstract: To cite this article: Amaal Eman Abdulle & Joukje van der Naalt (2020) The role of mood, posttraumatic stress, post-concussive symptoms and coping on outcome after MTBI in elderly patients,

Cited by 11 publications

References 53 publications

Mental Health Outcomes Across the Lifespan in Individuals With Persistent Post-Concussion Symptoms: A Scoping Review

Mental Health Outcomes Across the Lifespan in Individuals With Persistent Post-Concussion Symptoms: A Scoping Review

Systematic Review and Meta-analysis of Outcome after Mild Traumatic Brain Injury in Older People

Depressive Symptoms in Individuals With Persistent Postconcussion Symptoms: A Systematic Review and Meta-Analysis

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