Good Health-Related Quality of Life in Older Patients One Year after mTBI despite Incomplete Recovery: An Indication of the Disability Paradox?

• Published in: Journal of clinical medicine Vol. 13; no. 9; p. 2655
• Main Authors: Coffeng, Sophie M, Abdulle, Amaal Eman, van der Horn, Harm J, de Koning, Myrthe E, Ter Maaten, Jan C, Spikman, Jacoba M, van der Naalt, Joukje
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01.05.2024
• Subjects: Aged patients; Anxiety; Brain; Comorbidity; Coping; Education; Health aspects; Hospitals; Injuries; Mental depression; Mental health; Missing data; Patients; Perceptions; Population; Quality of life; Questionnaires; Stress; Trauma; Traumatic brain injury; Variables; Netherlands; aged; health-related quality of life; older; outcome assessment; mild traumatic brain injury
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm13092655

: Older adults (OAs) with mild traumatic brain injury (OA-mTBI) are a growing population, but studies on long-term outcomes and quality of life are scarce. Our aim was to determine the health-related quality of life (HRQoL) in OA-mTBI one year after injury and to assess the early predictors of HRQoL. : Data from a prospective follow-up study of 164 older (≥60 years) and 289 younger mTBI patients (<60 years) admitted to the emergency department were analyzed. Post-traumatic complaints, emotional distress and coping were evaluated 2 weeks post-injury using standardized questionnaires. At 12 months post-injury, HRQoL and functional recovery were determined with the abbreviated version of the World Health Organization Quality of Life scale and Glasgow Outcome Scale Extended (GOSE), respectively. : One year post-injury, 80% (n = 131) of the OA-mTBI rated their HRQoL as "good" or "very good", which was comparable to younger patients (79% (n = 226), = 0.72). Incomplete recovery (GOSE <8) was present in 43% (n = 69) of OA-mTBI, with 67% (n = 46) reporting good HRQoL. Two weeks post-injury, fewer OA-mTBI had (≥2) post-traumatic complaints compared to younger patients (68% vs. 80%, = 0.01). In the multivariable analyses, only depression-related symptoms (OR = 1.20 for each symptom, 95% CI = 1.01-1.34, < 0.01) were predictors of poor HRQoL in OA-mTBI. : Similar to younger patients, most OA-mTBI rated their HRQoL as good at one year after injury, although a considerable proportion showed incomplete recovery according to the GOSE, suggesting a disability paradox. Depression-related symptoms emerged as a significant predictor for poor HRQoL and can be identified as an early target for treatment after mTBI.