The Association of Age and Time Postinjury With Long-Term Emotional Outcome Following Traumatic Brain Injury

Objective: To examine the effect of age and time postinjury on emotional distress, 5 to 22 years following traumatic brain injury (TBI). Participants: One hundred twelve participants with mild to very severe TBI, aged 16 to 81 years at the time of injury, and 112 healthy controls matched for current age, gender, education, and estimated IQ. Main outcome measure: The Hospital Anxiety and Depression Scale (HADS). Results: The difference in HADS scores between participants with TBI and controls did not vary according to the separate variables of age at injury or time postinjury. There was an interaction between age at injury and time postinjury whereby the youngest group demonstrated higher HADS scores with longer time postinjury, whereas the older groups displayed lower HADS scores with longer time postinjury, relative to controls. Conclusions: Long-term emotional outcome following TBI is related to the combined influence of age and time postinjury. Higher levels of emotional distress, evident at longer time postinjury in younger individuals, are particularly concerning and warrant attention from clinicians.