Overall outcome, functioning, and disability in older adults 3 to 14 years after traumatic brain injury

Abstract Background Epidemiological studies show an increasing incidence of traumatic brain injury (TBI) among people aged 65 years and older. Advances in neurointensive care have improved survival after TBI. There is a need for knowledge about long‐term outcome after TBI among older survivors of TBI. Objective To describe the overall outcome, long‐term functioning, and disability of the participants in the Uppsala Long‐term outcome in Older adults with Traumatic brain injury Study (U‐LOTS), a cohort study assessing adults aged 60 years or older when admitted to a neurointensive care unit following a TBI, where 3 to 14 years had passed since the injury. Design Cross‐sectional cohort study. Setting Home and community settings. Interventions Not applicable. Participants Data were collected from 79 survivors of TBI (65% men; mean age 76 years, mean time since TBI 7 years). Main Outcome Measures The Glasgow Outcome Scale Extended (GOSE), the Functional Independence Measure (FIM), the Mayo‐Portland Adaptability‐4 (MPAI‐4), and the following sociodemographics and TBI characteristics: gender, age, marital status, vocational situation, rehabilitation, need of assistance, use of mobility devices, oropharyngeal dysphagia, impaired sense of smell and/or taste, prior brain disease, cause of accident, severity of TBI, comorbidities, dominant finding on first computed tomography scan, and assessment with GOSE 6 months after TBI. Results Falls (68%) and acute subdural hematoma (41%) were the most common cause and injury. For many participants (40%) the GOSE scores did not change between 6 months after TBI until the long‐term follow‐up, and a majority (57%) had a relatively good outcome as assessed with the MPAI‐4. GOSE, FIM, and MPAI‐4 Ability scores were significantly ( p < .05) correlated with injury severity. Marital status remained unchanged for 70% of the participants. Conclusions Older adults surviving a TBI may have a relatively favorable outcome. A major factor that determined long‐term outcome was injury severity.