Outcome after traumatic brain injury sustained in older adulthood: A one-year longitudinal study

Objective: The objective of this study was to explore the effects of traumatic brain injury (TBI) on cognition and functioning in older adults in a one-year longitudinal study. Methods: Participants with mild-to-moderate TBI were compared with an age-, gender-, and education-matched healthy comparison group on aspects of cognition. Neuropsychologic tests were administered at one year. Self-reported measures of functioning were completed at baseline, six months, and one year. Informants rated instrumental functioning at one year. Results: Sixty-nine subjects aged 50 years and over (mean: 67 years; standard deviation: 7.9) and a comparison group of 79 participants were assessed. Patients with TBI had poorer processing speed, verbal memory, language, and executive function; they self-reported more psychologic distress, psychosocial dysfunction, and postconcussive symptoms; and they were rated as more impaired in functioning than the comparison group. TBI of moderate severity accounted for most of the between-group differences. Conclusion: TBI, particularly of moderate severity, led to poorer cognitive and psychosocial functioning one year postinjury among older adults. The clinical significance of this may become more evident with time in this vulnerable population.