Functioning and disability from 10 to 16years after traumatic brain injury.

Abstract

With increased long-term survival after traumatic brain injury (TBI), there is a need to understand the life situation many years after the injury. In this study, we have assessed persons on average 16years after their injury and determined changes over 6years in overall outcome, living condition, marital status and vocational situation, and in their functioning and disability. Individuals (n=49, mean age 45years, 28-70years) who were assessed 6-15years (average 10years) post-TBI were reassessed 12-21years after their injury (average 16years) using internationally established TBI outcome measures. From the first to the second assessment, overall outcome using the Glasgow Outcome Scale (GOS) was stable for a large majority and no significant changes in marital status or vocational situation were found. There was some significant, but very small, decline regarding cognitive function, home integration and social integration. In the multiple regression analysis, there was a small significant decline in the Mayo-Portland Adaptability Inventory (MPAI-4) Adjustment subscale score for women with a moderate-to-severe injury. The very small changes over 6years imply that persons with a TBI can reach and maintain a stable level of functioning many years post-TBI. Women with a moderate-to-severe TBI seem to be more vulnerable and may experience a small decline in some aspects of their functioning related to anxiety, depression, irritability, pain and headache and fatigue. The relatively small sample requires further studies to confirm these findings.