We will desribe differences in participation across age groups after traumatic brain injury (TBI), with a focus on the effect of depression across the lifespan, using data from the 5-year from the TBI Model Systems National Database.
Objective : To determine differences in participation across age groups after traumatic brain injury (TBI)
Design : Secondary data analysis of the multicenter, prospective TBI Model Systems National Database
Setting : Community
Participants (or Animals, Specimens, Cadavers) : Community-dwelling adults ≥18 years old with moderate-severe TBI with complete participation and depression data at 5 years post-injury (n=3062)
Interventions : Not applicable
Main Outcome Measure(s) : Participation Assessment with Recombined Tools-Objective (PART-O) Subscales: 1) Productivity, 2) Social Relations, 3) Out and About
Results : Age groups were determined based on lifespan development stages: 18-25, 26-45, 46-65, 66-75, and ≥76 years old. We performed Games-Howell post-hoc comparisons by age group after Welch’s ANOVAs for each of the three PART-O subscales were all statistically significant. For Productivity, differences between all age groups were statistically significant, with the exception of 18-25 versus 26-45 year olds and 66-75 versus ≥76 year olds, with lower participation associated with older age. For Out and About, 18-25 year olds had significantly higher participation than all other groups except 26-45 year olds; 26-45 year olds had significantly higher participation than 46-65 year olds and ≥76 year olds. For Social Relations, 18-25 year olds and 26-45 year olds had significantly higher participation than 46-65 year olds, and ≥76 year olds had significantly lower participation than all other age groups.
Conclusions : Participation differed by age groups across the lifespan among community-dwelling adults 5 years post-TBI. These differences mirror age-related patterns in depression and life satisfaction after TBI, suggesting a link between mood, quality of life, and participation. However, future research should examine to what extent measurement bias (i.e. individual PART-O items functioning differently by age) affects assessment of participation as a measure of recovery or decline after TBI.