Participation differences by age and depression 5 years after moderate-to-severe traumatic brain injury

Abstract

Participation restrictions, including restrictions in employment, recreational activities, and social interactions, and depression are common after traumatic brain injury (TBI) and can profoundly affect individuals. Participation and depression demonstrate complex relationships with each other and over time as individuals age. This study (1) identified differences in participation between different age groups; (2) determined if participation differed between those with and without clinically significant depressive symptoms within each age group; and (3) determined the effect of the interaction between age groups and the presence or absence of clinically significant depressive symptoms on participation in community-dwelling adults with a moderate-to-severe TBI. Results indicate that, among community-dwelling adults 5 years post-TBI, there are significant differences in participation between age groups across the lifespan, with younger adults generally having higher levels of participation. Individuals with clinically significant depressive symptoms participate less than individuals without it within the same age group, except for adults over 65 years-old. For the productivity domain, age interacted with depressive symptoms, such that the presence of clinically significant depressive symptoms was associated with a larger difference in productivity in early-to-middle adulthood. Based on these findings, depression should be considered when providing interventions for participation and vice versa.

Keywords:

• Traumatic brain injury
• participation
• depression
• ageing
• neurorehabilitation
• lifespan

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible to the content and writing of the paper.

Additional information

Funding

The TBI Model Systems National Database is a multicenter study of the TBI Model Systems Centers Program, and is supported by the National Institute on Disability, Independent Living and Rehabilitation Research (NIDILRR) a center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). However, these contents do not necessarily reflect the opinions or views of the TBI Model Systems Centers, NIDILRR, ACL or HHS. Work on this manuscript was funded in part by NIDILRR grant 90DPTB0013-01-00 (Juengst).