UNDIAGNOSED HEALTH ISSUES IN INDIVIDUALS WITH TRAUMATIC BRAIN INJURY LIVING IN THE COMMUNITY

Objectives: To examine the self-reported prevalence of long-term healt h issues in individuals with traumatic brain injury (TBI) living in th e community. Design: A structured health interview. For individuals wi th TBI, the presence of a specific health-related issue with onset pos t-TBI and currently a problem at the time of the interview was explore d. For individuals without disability, a specific health-related issue was evaluated at time of interview. For each health issue, the propor tion of individuals with TBI experiencing post-TBI onset but current s ymptoms was contrasted with symptom reports of individuals without dis ability. Chi-square statistical analyses were used to determine signif icance. For individuals with TBI, logistic regressions were used to mo del the probability of having a particular health difficulty when four covariates were examined, such as age, gender, rime since onset of TB I, and duration of loss of consciousness (LOC). Setting: Urban, suburb an, and rural New York State. Participants: 338 individuals with TBI a nd 273 individuals without disability between the ages of 18 and 65 ye ars. Individuals with TBI were, on average, 10 years post-onset at the time of interview. Main Outcome Measures: Self-reported health issues reflective of neuroendocrine, neurological, immunosuppression, and ot her hearth issues. Results: Chronic health issues suggestive of ongoin g neuroendocrine dysfunctions (ie, changes in hair/skin texture, body temperature changes), neurologic difficulties (ie, headaches, seizures , balance difficulties, spasticity, sleep disturbances, loss of urinar y control), and arthritic complaints were significantly more common in individuals with TBI. The prevalence of many of these health-related difficulties was related to duration of LOC but not to time since inju ry. Age and gender effects were found, with older women with TBI more Likely to report thyroid conditions, sleep disturbances, loss of urina ry control, and arthritic changes. Women also reported greater frequen cy of headaches, colds, weight changes, and temperature changes post T BI. Conclusion: Health issues reflective of neuroendocrine, neurologic al, and arthritic difficulties are common long-term health issues for individuals with TBI. Proactive patient education, ongoing health scre ening with appropriate medical follow-up, and timely interventions for individuals with TBI are indicated. Longitudinal studies are necessar y to examine the natural course of post-TBI health difficulties.