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

von Seth, Charlotta ; Lewén, Anders ; Lannsjö, Marianne ; Enblad, Per and Lexell, Jan LU (2025) In PM and R
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:... (More)

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.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
in
PM and R
publisher
Wiley-Blackwell
external identifiers
  • pmid:40970315
  • scopus:105016663992
ISSN
1934-1482
DOI
10.1002/pmrj.70012
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2025 The Author(s). PM&R published by Wiley Periodicals LLC on behalf of American Academy of Physical Medicine and Rehabilitation.
id
4398f48c-0c84-4280-91ae-7570dfca26cb
date added to LUP
2025-12-09 13:52:06
date last changed
2025-12-09 13:55:29
@article{4398f48c-0c84-4280-91ae-7570dfca26cb,
  abstract     = {{<p>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 &lt;.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.</p>}},
  author       = {{von Seth, Charlotta and Lewén, Anders and Lannsjö, Marianne and Enblad, Per and Lexell, Jan}},
  issn         = {{1934-1482}},
  language     = {{eng}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{PM and R}},
  title        = {{Overall outcome, functioning, and disability in older adults 3 to 14 years after traumatic brain injury}},
  url          = {{http://dx.doi.org/10.1002/pmrj.70012}},
  doi          = {{10.1002/pmrj.70012}},
  year         = {{2025}},
}