In-depth assessment of quality of life and real life impact of mild traumatic brain injury in elderly by means of a focus group study

Brain Spine. 2023 Feb 25:3:101722. doi: 10.1016/j.bas.2023.101722. eCollection 2023.

Abstract

Traumatic Brain Injury (TBI) in the elderly population leads to more severe consequences than in young patients. However, the impact that TBI has on elderly patients' Quality of Life (QoL) has not been thoroughly investigated and is still unclear. Therefore, the main objective of this study is to qualitatively investigate changes in QoL after mild TBI in elderly patients. A focus group interview was conducted with 6 mild TBI patients, with a median age of 74 years old, admitted to the University Hospitals Leuven (UZ Leuven) between 2016 and 2022. The data analysis was performed following the guide provided by Dierckx de Casterlé et al. in 2012, using Nvivo software. Three themes emerged from the analysis: functional disturbances and symptoms, daily life after TBI, and life quality, feelings and satisfaction. The most reported factors that deteriorated QoL 1-5 years post-TBI in our cohort were the lack of support from partners and families, changes in self-perception and social life, tiredness, balance disturbances, headache, cognitive deterioration, changes in physical health, senses' disturbances, changes in sexual life, sleep problems, speech disturbances and dependence for daily life activities. No symptoms of depression or feelings of shame were reported. The acceptance of the situation and hope for improvement were shown to be the most important coping mechanisms for these patients. In conclusion, mild TBI in elderly patients frequently leads to changes in self-perception, daily life activities and social life 1-5 years after the injury, which could contribute to a loss of independence and QoL deterioration. The acceptance of the situation and a good support network seem to be protective factors for these patients' well-being after TBI.

Keywords: Elderly; Qualitative study; Quality of life; Traumatic brain injury.