Age and functioning after mild traumatic brain injury: the acute picture

Hypothesis: There will be acute harbingers of poor outcome following mild t raumatic brain injury (TBI) in the elderly. Participants: Twenty-six subjects age 60 and over were compared to 30 subje cts aged 18-59, seen within 1 month, on average, following a mild TBI. Main outcome measures: Functioning was assessed using the Glasgow Outcome S cale (GOS), a global measure of outcome, as well as self-report measures of psychosocial functioning, physical symptoms and psychological distress. Results: Contrary to the hypothesis, the older group did better than their younger counterparts on the GOS (p=0.002), and reported less psychosocial i mpairment (p<0.0001), less psychological distress (p=0.002), and less physi cal symptoms (p=0.005). However, once employment was controlled for, these results only approached statistical significance. Discussion: The assumption that elderly subjects have a worse outcome follo wing TBI needs to be reconsidered, at least within the acute recovery perio d. The importance of psychosocial factors as modifiers of outcome according to age are emphasized. Whether this finding holds true over a longer follo w-up period is the subject of ongoing research.