Does age matter? A mixed methods study examining determinants of good recovery and resilience in young and middle-aged adults following moderate-to-severe traumatic brain injury.

Abstract

To examine whether age contributes to functional recovery and resilience after moderate-to-severe traumatic brain injury. The ability to recover may change across the lifespan, but the influence of age on brain injury outcome is understudied. Mixed methods study. All adults of working age (18-64years) discharged from a level I trauma centre between 2010-2013 after sustaining a moderate-to-severe traumatic brain injury were considered. Functional recovery was assessed during a telephone interview with the Glasgow Outcome Scale-Extended 12-36months postinjury. A subgroup completed the Connor-Davidson Resilience Scale and a face-to-face interview about resilience. Ninety-seven young (mean age: 27years; 75% male) and 47 middle-aged brain trauma survivors (mean age: 53years; 75% male) completed the telephone interview. Eight young and five middle-aged adults were also assessed for resilience. Overall, young participants experienced more severe head injuries. Yet, they achieved slightly higher levels of functional recovery compared with middle-aged ones as per the Glasgow Outcome Scale-Extended. Controlling for CT scan findings and posttraumatic amnesia duration, age was not found to be associated to functional recovery in adults of working age. Although both groups showed similar levels of resilience, young participants discussed the challenges related to "having more time on their hands" and "being a changed person", two elements perceived positively by middle-aged ones. While age does not appear to interfere with functional recovery in adults of working age, younger brain trauma survivors could benefit from nursing interventions to strengthen their resilience process related to re-employment orientation and identity.