The role of mood, post-traumatic stress, post-concussive symptoms and coping on outcome after MTBI in elderly patients

Int Rev Psychiatry. 2020 Feb;32(1):3-11. doi: 10.1080/09540261.2019.1664421. Epub 2019 Oct 8.

Abstract

Elderly patients are at increased risk for persistent complaints after mild traumatic brain injury (MTBI). This study aimed to investigate the role of post-concussive symptoms, mood, post-traumatic stress, and coping on functional outcome in elderly with MTBI. Information on mood, post-concussive symptoms, post-traumatic stress, and coping was collected 2 weeks post-injury. Six months post-injury functional outcome was assessed with the Glasgow Outcome Scale Extended. One hundred and sixty-two patients aged ≥ 60 years were included, 55% male, mean age = 71 (±6.2) years. The most frequent cause of injury was falls from standing height (75%). Two weeks post-injury anxiety, depression, and post-traumatic stress were present in 15%, 12%, and 38% of patients, respectively, with 73% reporting post-concussive symptoms. Avoidant coping was the most frequently used coping style. Six months post-injury, 44% showed incomplete recovery. Higher depression scores (OR = 0.87, p = 0.005) and number of post-concussive symptoms (OR = 0.91, p = 0.03) were associated with incomplete recovery. Half of the elderly showed incomplete recovery 6 months after MTBI, with early depression or post-concussive symptoms as important factors. Coping style was not related to outcome. These results underline the need for a different approach in elderly patients, focusing on other predicting factors and fall prevention strategies.

Keywords: Mild traumatic brain injury; complaints; coping; elderly; mood; outcome; stress.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological / physiology*
  • Aged
  • Aged, 80 and over
  • Aging / physiology*
  • Anxiety / physiopathology*
  • Depression / physiopathology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care
  • Post-Concussion Syndrome / physiopathology*
  • Stress Disorders, Post-Traumatic / physiopathology*