Predictors of 1-Year Global Outcomes After Traumatic Brain Injury Among Older Adults: A NIDILRR Traumatic Brain Injury Model Systems Study

Baker-Sparr, Christina; Dahdah, Marie; Dams-O’Connor, Kristen; Dreer, Laura E.; OʼNeil-Pirozzi, Therese M.; Novack, Thomas A.

doi:10.1177/0898264318819197

Cited by 6 publications

(12 citation statements)

References 54 publications

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“…17,39,65 In addition, difficulties to generalizability were seen in studies with specific foci, having limited sample sizes available that satisfied their inclusion criteria. 14,18,20,23,27,28,[32][33][34]38,40,50,53,55,[57][58][59][60][61][62]64,[66][67][68][69][70][71] Thirty of 74 articles (41%) reported their limited ability to generalize to the overall TBI population, including those under-represented in the TBIMS data sets due to loss of follow-up or by database collection methods. Other factors impacting generalizability include sample size and missing data, which is a limitation in itself.…”

Section: Resultsmentioning

confidence: 99%

“…Other factors impacting generalizability include sample size and missing data, which is a limitation in itself. 14,18,20,23,27,28,[32][33][34]38,40,50,53,55,[57][58][59][60][61][62]64,[66][67][68][69][70][71] In addition, certain variable groups such as ''race'' were under-or over-representative of the U.S. population overall, therefore serving as a limitation to generalizability in results due to the unequal representation of groups within variables. 60 In many studies, cohorts were dichotomized into sub-cohorts based on specific thresholds 21,23,[28][29][30][31]34,37,41,45,55,60,61,68,69,72,73 ; therefore caution is required when applying these findings to a more general population.…”

Section: Resultsmentioning

confidence: 99%

“…Various measurement tools were mentioned as limitations in studies, being compared to other modes of assessment to define outcomes. Examples of measures mentioned as limitations include: the GCS to measure initial head injury severity, 17 FIM as a functional and cognitive measure, 34,71,72 diffusion tensor imaging (DTI) scanner resolution, 27 GOS-E, and DRS. 77,78 As there are several different modes of measuring variables across institutions, this leads to slight differences in the information being collected.…”

Section: Resultsmentioning

confidence: 99%

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The Traumatic Brain Injury Model Systems National Database: A Review of Published Research

Tso

Saha

Cusimano

2021

Neurotrauma Reports

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The Traumatic Brain Injury Model Systems (TBIMS) is the largest longitudinal TBI data set in the world. Our study reviews the works using TBIMS data for analysis in the last 5 years. A search (2015-2020) was conducted across PubMed, EMBASE, and Google Scholar for studies that used the National Institute on Disability, Independent Living and Rehabilitation Research NIDILRR/VA-TBIMS data. Search terms were as follows: [''TBIMS'' national database] within PubMed and Google Scholar, and [''TBIMS' ' AND national AND database] on EMBASE. Data sources, study foci (in terms of data processing and outcomes), study outcomes, and follow-up information usage were collected to categorize the studies included in this review. Variable usage in terms of TBIMS' form-based variable groups and limitations from each study were also noted. Assessment was made on how TBIMS' objectives were met by the studies. Of the 74 articles reviewed, 23 used TBIMS along with other data sets. Fifty-four studies focused on specific outcome measures only, 6 assessed data aspects as a major focus, and 13 explored both. Sample sizes of the included studies ranged from 11 to 15,835. Forty-two of the 60 longitudinal studies assessed follow-up from 1 to 5 years, and 15 studies used 10 to 25 years of the same. Prominent variable groups as outcome measures were ''Employment,'' ''FIM,'' ''DRS,'' ''PART-O,'' ''Satisfaction with Life,'' ''PHQ-9,'' and ''GOS-E.'' Limited numbers of studies were published regarding tobacco consumption, the Brief Test of Adult Cognition by Telephone (BTACT), the Supervision Rating Scale (SRS), general health, and comorbidities as variables of interest. Generalizability was the most significant limitation mentioned by the studies. The TBIMS is a rich resource for large-sample longitudinal analyses of various TBI outcomes. Future efforts should focus on under-utilized variables and improving generalizability by validation of results across large-scale TBI data sets to better understand the heterogeneity of TBI.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

The Traumatic Brain Injury Model Systems National Database: A Review of Published Research

Tso

Saha

Cusimano

2021

Neurotrauma Reports

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“…Cognitive impairments are among the most common consequences of TBI in older adults and are an important predictor of post‐injury functioning and independence 17,18 . Among older adults, TBI is associated with impairments in a number of cognitive domains including attention, executive functioning, 7,19 memory, 6 and social cognition, 20 both in the subacute 19 and chronic 7,20 phases of recovery.…”

Section: Introductionmentioning

confidence: 99%

“…Identification of factors associated with cognitive outcomes of older adults with TBI after IRF care is an early step toward strategic planning to meet the TBI‐related cognitive rehabilitation needs of older adults within the IRF environment and improving cognitive outcomes for this population 18,22,32 . The objective of this study was to identify patient, clinical, and IRF characteristics associated with cognitive recovery among older adults with TBI who received IRF care.…”

Section: Introductionmentioning

confidence: 99%

Predictors of cognitive gains during inpatient rehabilitation for older adults with traumatic brain injury

Byom

Zhao

Yang

et al. 2022

PM&R

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Introduction: Traumatic brain injury (TBI) among older adults is increasing and can affect cognition. To effectively meet the rehabilitation needs of older adults, a clearer picture is needed of patient-, clinical-, and facility-level characteristics that affect cognitive recovery during inpatient rehabilitation facility (IRF) stays. Objective: To identify patient, clinical, and facility factors associated with cognitive recovery among older adults with TBI who received IRF care. Design: Secondary data analysis. Setting: Uniform Data System for Medical Rehabilitation-participating IRFs in the United States. Patients: Patients were 65 to 99 years of age at IRF admission for TBI. Participants received IRF care between 2002 and 2018 (N = 137,583); 56.3% were male; 84.2% were white; mean age was 78.7 years. Main Outcome Measure: Change in Functional Independence Measure Cognitive Score (FIM-Cognitive) from IRF admission to discharge, categorized as favorable (FIM-cognitive score gains ≥3 points) or poor (FIM-cognitive score gains <3 points) cognitive outcomes. Interventions: Not applicable.Results: Patients had greater odds of favorable cognitive recovery if they were female (adjusted odds ratio [aOR] 1.05, 95% confidence interval [CI] 1.05-1.08), had higher motor functioning at IRF admission (aOR 1.03, 95% CI 1.03-1.04), longer length of stay (aOR 1.07, 95% CI 1.06-1.07), or received care at a freestanding IRF (vs. hospital rehab unit) (aOR 1.57, 95% CI 1.52-1.61). Patients who were older (aOR 0.99, 95% CI 0.98-0.99), Black (aOR 0.79, 95% CI 0.75-0.83), Hispanic or Latino (aOR 0.97, 95% CI 0.91-1.02), or were part of another racial or ethnic group (aOR 0.85, 95% CI 0.81-0.90) (vs. White), had high-cost comorbid conditions (aOR 0.71, 95% CI 0.65-0.76), or who had higher cognitive functioning at IRF admission (aOR 0.90, 95% CI 0.90-0.91) had lower odds of favorable cognitive recovery. Conclusions: Patient (age, sex, race, ethnicity), clinical (level of functioning at IRF admission, length of stay) and facility (e.g., freestanding IRF) factors contributed to the cognitive recoveries of older adults during IRF stays.Disclosure: None.

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Traumatic Brain Injury in Older Adults: Epidemiology, Etiology, Rehabilitation, and Outcomes

Mattingly¹,

Roth

2022

Perspect ASHA SIGs

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Purpose: Traumatic brain injury (TBI) is a major public health problem, affecting millions of people worldwide each year. TBI presents as a major cause of death and disability in older adults, which is significant in the setting of older adults living longer. Falls are the leading cause of TBI in older adults, and normal sensory, motor, and cognitive changes that occur with aging increase the risk of falling. Multiple medical and cognitive comorbidities put older adults at increased risk for sustaining a TBI, and complicate recovery. Preexisting comorbid conditions, such as hypertension, diabetes, and heart disease, when combined with polypharmacy and aging effects compound the risks, severity, and outcomes following TBI. This clinical focus article addresses the normal effects of aging, the epidemiology of aging, and the relationship of aging to risks, consequences, and prognosis following TBI in older adults. In addition, discussion focuses on medical care and treatment, acute and chronic consequences, and assumptions and controversies in approaches to management of acute TBI in this population. The processes for assessment and treatment of cognitive communication during rehabilitation are explained in detail, including specific measures and strategies for both the acute and chronic phases of rehabilitation. Conclusions: Outcomes following TBI in older adults include persisting cognitive and functional limitations that often require some level of support. However, studies have shown that there are elderly patients with severe TBI who benefit from rehabilitation and may have more favorable outcomes. Determining prognosis after TBI is challenging relative to long-term functional consequences, due to the aging process. Therefore, the best intervention for TBI in older adults is prevention of TBI. As the aging population continues to increase in the United States, the need to design and implement evidence-based, cost-effective measures that focus on prevention of the leading causes of TBI in older adults becomes more urgent.

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Predictors of 1-Year Global Outcomes After Traumatic Brain Injury Among Older Adults: A NIDILRR Traumatic Brain Injury Model Systems Study

Cited by 6 publications

References 54 publications

The Traumatic Brain Injury Model Systems National Database: A Review of Published Research

The Traumatic Brain Injury Model Systems National Database: A Review of Published Research

Predictors of cognitive gains during inpatient rehabilitation for older adults with traumatic brain injury

Traumatic Brain Injury in Older Adults: Epidemiology, Etiology, Rehabilitation, and Outcomes

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