PTOTCohortArchives of physical medicine and rehabilitation2021

Association of Lifetime TBI and Military Employment with Late Life ADL Functioning: A Population-Based Prospective Cohort Study.

Laura Tabio, Rod L Walker, Paul K Crane and 6 others

PMID 34283993

WHAT IT FOUND

Older adults with a past head injury involving loss of consciousness reported more difficulties with daily activities at study entry than those without such injury.

However, the rate at which these difficulties increased over time was not significantly different between the groups.

Key findings

01Women with a history of loss-of-consciousness head injury before age 40 had an expected number of daily activity difficulties 44% higher at baseline compared to women with no such history.

02Men with a history of loss-of-consciousness head injury had higher expected numbers of daily activity difficulties at baseline, whether the injury occurred before age 40 or at age 40 and older.

03History of military employment was not associated with the number of daily activity difficulties at baseline or the rate of change over time for either men or women.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTs

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What it does not show

The cohort was predominantly white, well-educated, and relatively high-functioning, with most participants reporting little to no ADL difficulty throughout the study. TBI history was based on self-report of loss of consciousness, which may miss mild TBIs without LOC or rely on recall accuracy. Military employment was defined by longest or second-longest occupation, potentially missing brief service periods. Participants with dementia at baseline were excluded, and follow-up was censored upon dementia diagnosis, which may limit generalizability to those with cognitive impairment.

Declared interests

The study was supported by the National Institute on Aging and the National Institute of Nursing Research (NIH). The authors declared no conflicts of interest.

The easy way to misread this

Do not assume that a history of TBI predicts a faster rate of functional decline in late life. While patients with TBI history had more difficulties at the start of the study, the speed at which their abilities worsened over time was not significantly different from those without TBI history.

Read it on PubMed →