Living status and multidomain clinical outcomes in adults following acute mild traumatic brain injury

Background The objective of this study was to evaluate the role of living status in multidomain clinical outcomes in adults following acute mild traumatic brain injury (mTBI).Methods Adults presenting to emergency departments or a specialty concussion clinic within < 72 hours (h) of mTBI were enrolled. Multidomain clinical measures (e.g. Concussion Clinical Profile Screen [CP Screen], Patient Health Questionnaire 9 [PHQ-9], Post-Traumatic Stress Disorder Checklist [PCL-5], Perceived Stress Scale [PSS]) were collected at <72 h and 10 days (d) post-injury. Participants were grouped by living status: alone (Alone), with a spouse/significant other/roommate (Cohabitant), or with a partner and children/extended family (Family). Two-way mixed-effects models evaluated the interaction of group and time on clinical outcomes.Results One hundred fourteen participants (age = 33.2 ± 13.8 years; 63F) were enrolled: 27 (24%) in the Alone group, 41 (36%) Cohabitant, and 46 (40%) Family. A significant interaction was observed for the CP Screen Cognitive/Fatigue (F[2,51] = 5.5, p = 0.007), PHQ-9 (F[2,49] = 4.3, p = 0.020), PCL-5 (F[2,51] = 3.3, p = 0.044), and PSS (F[2,50] = 3.9 , p = 0.027). The Alone group exhibited significant increases in Cognitive/Fatigue problems (Δ3.1, p < 0.001), depression symptoms (Δ5.4, p < 0.001), and PTSD (Δ10.1, p = 0.006), but a significant decrease in perceived stress (Δ-4.5, p = 0.012) over time compared to the Cohabitant and Family groups (p > 0.05).Conclusions Adults living alone demonstrated a significant increase in cognitive/fatigue, depression, and stress-related symptoms from <72 h to 10d post-mTBI compared to those living with a cohabitant/family.