Quality of life after traumatic brain injury: a cross-sectional analysis uncovers age- and sex-related differences over the adult life span

Nikolaus Plesnila,Maria Teresa Ferretti,Philipp Probst,Barbara Schäpers,Maria Carmela Tartaglia,Klaus Jahn,Friedemann Müller,Katrin Rauen,Claudia B Späni,Lara Reichelt

doi:10.1007/s11357-020-00273-2

Abstract

Traumatic brain injury (TBI) is the leading cause of disability in the working population and becomes increasingly prevalent in the elderly. Thus, TBI is a major global health burden. However, age- and sex-related long-term outcome regarding patient’s health-related quality of life (HRQoL) is yet not clarified. In this cross-sectional study, we present age- and sex-related demographics and HRQoL up to 10 years after TBI using the Quality of Life after Brain Injury (QOLIBRI) instrument. The QOLIBRI total score ranges from zero to 100 indicating good (≥ 60), moderate (40–59) or unfavorable (< 40) HRQoL. Two-thirds of the entire chronic TBI cohort (102 males; 33 females) aged 18–85 years reported good HRQoL up to 10 years after TBI. TBI etiology differed between sexes with females suffering more often from traffic- than fall-related TBI (p = 0.01) with increasing prevalence during aging (p = < 0.001). HRQoL (good/moderate/unfavorable) differed between sexes (p < 0.0001) with 17% more females reporting moderate outcome (p = 0.01). Specifically, older females (54–76-years at TBI) were affected, while males constantly reported good HRQoL (p = 0.017). Cognition (p = 0.014), self-perception (p = 0.009), and emotions (p = 0.016) rather than physical problems (p = 0.1) constrained older females’ HRQoL after TBI. Experiencing TBI during aging does not influence HRQoL outcome in males but females suggesting that female brains cope less well with a traumatic injury during aging. Therefore, older females need long-term follow-ups after TBI to detect neuropsychiatric sequels that restrict their quality of life. Further investigations are necessary to uncover the mechanisms of this so far unknown phenomenon.

Highlights

Traumatic brain injury (TBI) is the number one cause of mortality among children and young adults and becomes increasingly prevalent among the elderly [1]
Switzerland cross-sectional study, we present age- and sex-related demographics and healthrelated quality of life (HRQoL) up to 10 years after TBI using the Quality of Life after Brain Injury (QOLIBRI) instrument
Experiencing TBI during aging does not influence HRQoL outcome in males but females suggesting that female brains cope less well with a traumatic injury during aging

Summary

Introduction

Traumatic brain injury (TBI) is the number one cause of mortality among children and young adults and becomes increasingly prevalent among the elderly [1]. Disability-adjusted life years (DALY) between 1990 and 2013 [4, 5]. TBI outcome research has mainly focused on the patient’s physical performance using the Extended Glasgow Outcome Scale (GOSE) at 6 and 12 months post-TBI. When assessing the TBI long-term outcome beyond 12 months, healthrelated quality of life (HRQoL) is thought to be more suitable since it integrates more relevant outcome measures than merely physical function [1]. TBI outcome is influenced by the brain injury itself and by the individual’s sex- and gender-related experiences which play a major role for the long-term outcome after TBI [10]

Methods

Results

Conclusion