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  1. Article ; Online: The impact of age on outcome 2 years after traumatic brain injury: Case control study.

    Downing, Marina G / Carty, Meagan / Olver, John / Ponsford, Michael / Acher, Rose / Mckenzie, Dean / Ponsford, Jennie L

    Annals of physical and rehabilitation medicine

    2024  Volume 67, Issue 5, Page(s) 101834

    Abstract: Background: Age is associated with outcome after traumatic brain injury (TBI). However, there are mixed findings across outcome domains and most studies lack controls.: Objectives: This cross-sectional study examined the association between age group ...

    Abstract Background: Age is associated with outcome after traumatic brain injury (TBI). However, there are mixed findings across outcome domains and most studies lack controls.
    Objectives: This cross-sectional study examined the association between age group (15-24 years, 25-34 years, 35-44 years, 45-54 years, 55-64 years, and 65 years or more) and outcomes 2 years after TBI in independence in daily activities, driving, public transportation use, employment, leisure activities, social integration, relationships and emotional functioning, relative to healthy controls. It was hypothesized that older individuals with TBI would have significantly poorer outcomes than controls in all domains except anxiety and depression, for which it was expected they would show better outcomes. Global functional outcome (measured using the Glasgow Outcome Scale-Extended) was also examined, and we hypothesized that older adults would have poorer outcomes than younger adults.
    Methods: Participants were 1897 individuals with TBI (mean, SD age 36.7, 17.7 years) who completed measures 2 years post-injury and 110 healthy controls (age 38.3, 17.5 years).
    Results: Compared to controls, individuals with TBI were less independent in most activities of daily living, participated less in leisure activities and employment, and were more socially isolated, anxious and depressed (p < 0.001). Those who were older in age were disproportionately less likely to be independent in light domestic activities, shopping and driving; and participated less in occupational activities relative to controls. Functional outcome was significantly higher in the youngest age group than in all older age groups (p < 0.001), but the younger groups were more likely to report being socially isolated (p < 0.001), depressed (p = 0.005) and anxious (p = 0.02), and less likely to be married or in a relationship (p < 0.001).
    Conclusion: A greater focus is needed on addressing psychosocial issues in younger individuals with TBI, whereas those who are older may require more intensive therapy to maximise independence in activities of daily living and return to employment.
    Language English
    Publishing date 2024-03-21
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 2480363-7
    ISSN 1877-0665 ; 1877-0657
    ISSN (online) 1877-0665
    ISSN 1877-0657
    DOI 10.1016/j.rehab.2024.101834
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: "It's Not Only the Injury but Also the Kind of Head." Factors Influencing Outcome After Traumatic Brain Injury.

    Ponsford, Jennie L / Carty, Meagan / Olver, John / Ponsford, Michael / Acher, Rose / McKenzie, Dean / Downing, Marina G

    Archives of physical medicine and rehabilitation

    2024  

    Abstract: Objective: Given the high variability in traumatic brain injury (TBI) outcomes and relative lack of examination of the influence of noninjury factors on outcome, this study aimed to examine factors associated with functional outcome at 1 and 2 years ... ...

    Abstract Objective: Given the high variability in traumatic brain injury (TBI) outcomes and relative lack of examination of the influence of noninjury factors on outcome, this study aimed to examine factors associated with functional outcome at 1 and 2 years after moderate to severe TBI, including both preinjury and injury-related factors.
    Design: Observational cohort study.
    Setting: Inpatient hospital recruitment with outpatient follow-up at 1 and 2 years post injury.
    Participants: Individuals with moderate to severe TBI were recruited prospectively into a Longitudinal Head Injury Outcome Study. Of the eligible 3253 individuals who were eligible, 1899 participants consented to the study (N=1899).
    Main outcome measure: Functional outcome was measured using the Glasgow Outcome Scale-Extended (GOS-E).
    Results: 1476 participants (73.6% males) and 1365 participants (73% males) completed the GOS-E at 1 and 2 years post injury. They had a mean age at injury of 40 years and mean duration of post-traumatic amnesia (PTA) of 26 days. Good recovery, representing return to previous activities on the GOS-E (score 7-8), was present in 31% of participants at 1 year post injury and 33.5% at 2 years post injury. When predictor variables were entered into regression together, good outcome was significantly associated with not being from a culturally and linguistically diverse background and not having preinjury mental health or alcohol treatment, shorter PTA duration, and absence of limb injuries at both 1 and 2 years; higher education was also a significant predictor at 1 year post injury.
    Conclusions: Alongside consideration of injury severity, consideration of preinjury factors is important to inform prognostication and rehabilitation planning.
    Language English
    Publishing date 2024-03-16
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80057-0
    ISSN 1532-821X ; 0003-9993
    ISSN (online) 1532-821X
    ISSN 0003-9993
    DOI 10.1016/j.apmr.2024.03.003
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Longitudinal follow-up of patients with traumatic brain injury: outcome at two, five, and ten years post-injury.

    Ponsford, Jennie L / Downing, Marina G / Olver, John / Ponsford, Michael / Acher, Rose / Carty, Meagan / Spitz, Gershon

    Journal of neurotrauma

    2014  Volume 31, Issue 1, Page(s) 64–77

    Abstract: The deleterious consequences of traumatic brain injury (TBI) impair capacity to return to many avenues of pre-morbid life. However, there has been limited longitudinal research examining outcome beyond five years post-injury. The aim of this study was to ...

    Abstract The deleterious consequences of traumatic brain injury (TBI) impair capacity to return to many avenues of pre-morbid life. However, there has been limited longitudinal research examining outcome beyond five years post-injury. The aim of this study was to examine aspects of function, previously shown to be affected following TBI, over a span of 10 years. One hundred and forty one patients with TBI were assessed at two, five, and 10 years post-injury using the Structured Outcome Questionnaire. Fatigue and balance problems were the most common neurological symptoms, with reported rates decreasing only slightly during the 10-year period. Mobility outcomes were good in more than 75% of patients, with few participants requiring aids for mobility. Changes in cognitive, communication, behavioral, and emotional functions were reported by approximately 60% of the sample at all time points. Levels of independence in activities of daily living were high during the 10-year period, and as many as 70% of subjects returned to driving. Nevertheless, approximately 40% of patients required more support than before their injury. Only half the sample returned to previous leisure activities and fewer than half were employed at each assessment time post-injury. Although marital status remained stable over time, approximately 30% of participants reported difficulties in personal relationships. Older age at injury did not substantially alter the pattern of changes over time, except in employment. Overall, problems that were evident at two years post-injury persisted until 10 years post-injury. The importance of these findings is discussed with reference to rehabilitation programs.
    MeSH term(s) Activities of Daily Living ; Adolescent ; Adult ; Aged ; Brain Injuries/physiopathology ; Cognition/physiology ; Disability Evaluation ; Emotions/physiology ; Employment ; Female ; Follow-Up Studies ; Humans ; Injury Severity Score ; Longitudinal Studies ; Male ; Middle Aged ; Recovery of Function/physiology ; Surveys and Questionnaires ; Treatment Outcome ; Young Adult
    Language English
    Publishing date 2014-01-01
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 645092-1
    ISSN 1557-9042 ; 0897-7151
    ISSN (online) 1557-9042
    ISSN 0897-7151
    DOI 10.1089/neu.2013.2997
    Database MEDical Literature Analysis and Retrieval System OnLINE

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