The impact of major depression on outcome following mild-to-moderate traumatic brain injury in older adults

Background: Major depression is common following traumatic brain injury (TBI), yet no studies to date have explored its relationship to psychosocial outcome in older adults with TBI. Methods: A consecutive sample of seventy-seven older patients with mild-to-moderate TBI was assessed for the presence of major depression within 2 months of injury, and followed prospectively for 1 year. Those with major depression were compared with those without on measures of psychosocial outcome, instrumental activities of daily living (IADL). Results: Patients with major depression (15.6%) reported higher degrees of psychological distress, psychosocial dysfunction, and post-concussive symptoms than those without, and were rated as having poorer IADL performance. Limitations: The present study was limited to a clinical population, and there were significant attrition rates. Conclusions: Major depression in the first few months after TBI in older adults has persisting adverse effects on outcome, highlighting its significance in this population, and suggesting early attention to treatment. (c) 2006 Elsevier B.V. All rights reserved.