1
|
Downing MG, Carty M, Olver J, Ponsford M, Acher R, Mckenzie D, Ponsford JL. The impact of age on outcome 2 years after traumatic brain injury: Case control study. Ann Phys Rehabil Med 2024; 67:101834. [PMID: 38518520 DOI: 10.1016/j.rehab.2024.101834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 02/07/2024] [Accepted: 02/10/2024] [Indexed: 03/24/2024]
Abstract
BACKGROUND Age is associated with outcome after traumatic brain injury (TBI). However, there are mixed findings across outcome domains and most studies lack controls. OBJECTIVES This cross-sectional study examined the association between age group (15-24 years, 25-34 years, 35-44 years, 45-54 years, 55-64 years, and 65 years or more) and outcomes 2 years after TBI in independence in daily activities, driving, public transportation use, employment, leisure activities, social integration, relationships and emotional functioning, relative to healthy controls. It was hypothesized that older individuals with TBI would have significantly poorer outcomes than controls in all domains except anxiety and depression, for which it was expected they would show better outcomes. Global functional outcome (measured using the Glasgow Outcome Scale-Extended) was also examined, and we hypothesized that older adults would have poorer outcomes than younger adults. METHODS Participants were 1897 individuals with TBI (mean, SD age 36.7, 17.7 years) who completed measures 2 years post-injury and 110 healthy controls (age 38.3, 17.5 years). RESULTS Compared to controls, individuals with TBI were less independent in most activities of daily living, participated less in leisure activities and employment, and were more socially isolated, anxious and depressed (p < 0.001). Those who were older in age were disproportionately less likely to be independent in light domestic activities, shopping and driving; and participated less in occupational activities relative to controls. Functional outcome was significantly higher in the youngest age group than in all older age groups (p < 0.001), but the younger groups were more likely to report being socially isolated (p < 0.001), depressed (p = 0.005) and anxious (p = 0.02), and less likely to be married or in a relationship (p < 0.001). CONCLUSION A greater focus is needed on addressing psychosocial issues in younger individuals with TBI, whereas those who are older may require more intensive therapy to maximise independence in activities of daily living and return to employment.
Collapse
Affiliation(s)
- Marina G Downing
- Turner Institute for Brain and Mental Health, School of Psychological Science, Monash University, Melbourne, Australia; Monash-Epworth Rehabilitation Research Centre, Melbourne, Australia; Epworth HealthCare, Melbourne, Australia.
| | - Meagan Carty
- Monash-Epworth Rehabilitation Research Centre, Melbourne, Australia; Epworth HealthCare, Melbourne, Australia
| | - John Olver
- Epworth HealthCare, Melbourne, Australia; Faculty of Medicine, Monash University, Melbourne, Australia
| | | | - Rose Acher
- Epworth HealthCare, Melbourne, Australia
| | | | - Jennie L Ponsford
- Turner Institute for Brain and Mental Health, School of Psychological Science, Monash University, Melbourne, Australia; Monash-Epworth Rehabilitation Research Centre, Melbourne, Australia; Epworth HealthCare, Melbourne, Australia
| |
Collapse
|
2
|
Lord K, Zimmerman J, Duff MC, Brown-Schmidt S. Memory for social media images following traumatic brain injury. Brain Inj 2023; 37:1334-1344. [PMID: 37902249 PMCID: PMC10842253 DOI: 10.1080/02699052.2023.2272902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 10/15/2023] [Indexed: 10/31/2023]
Abstract
PRIMARY OBJECTIVE An emerging body of research examines the role of computer-mediated communication in supporting social connection in persons with traumatic brain injury (TBI). We examine the cognitive impacts of engaging with images posted to social media for persons with moderate-severe TBI. RESEARCH DESIGN Prior work shows that after viewing social media posts, adults have better memory for posts when they generate a comment about the post. We examined if persons with TBI experience a memory benefit for commented-upon social media images similar to non-injured comparison participants. METHODS AND PROCEDURES 53 persons with moderate-to-severe TBI and 52 non-injured comparison participants viewed arrays of real social media images and were prompted to comment on some of them. After a brief delay, a surprise two-alternative forced choice recognition memory test measured memory for these images. MAIN OUTCOMES AND RESULTS Persons with TBI remembered social media images at above-chance levels and experienced a commenting-related memory boost much like non-injured comparison participants. CONCLUSIONS These findings add to a growing literature on the potential benefits of social media use in individuals with TBI and point to the benefits of active engagement for memory in social media contexts in TBI.
Collapse
Affiliation(s)
- Kaitlin Lord
- Vanderbilt University, Department of Psychology and Human Development
| | - Jordan Zimmerman
- Vanderbilt University, Department of Psychology and Human Development
- Harvard University, Department of Psychology
| | - Melissa C. Duff
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center
| | | |
Collapse
|
3
|
Zhao F, Lim H, Morrow EL, Turkstra LS, Duff MC, Mutlu B. Designing evidence-based support aids for social media access for individuals with moderate-severe traumatic brain injury: A preliminary acceptability study. Front Digit Health 2022; 4:991814. [PMID: 36606124 PMCID: PMC9808081 DOI: 10.3389/fdgth.2022.991814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 10/31/2022] [Indexed: 01/07/2023] Open
Abstract
Background Adults with traumatic brain injury (TBI) report significant barriers to using current social media platforms, including cognitive overload and challenges in interpreting social cues. Rehabilitation providers may be tasked with helping to address these barriers. Objectives To develop technological supports to increase social media accessibility for people with TBI-related cognitive impairments and to obtain preliminary data on the perceived acceptability, ease of use, and utility of proposed technology aids. Methods We identified four major barriers to social media use among individuals with TBI: sensory overload, memory impairments, misreading of social cues, and a lack of confidence to actively engage on social media platforms. We describe the process of developing prototypes of support aids aimed at reducing these specific social media barriers. We created mock-ups of these prototypes and asked 46 community-dwelling adults with TBI (24 females) to rate the proposed aids in terms of their acceptability, ease of use, and utility. Results Across all aids, nearly one-third of respondents agreed they would use the proposed aids frequently, and the majority of respondents rated the proposed aids as easy to use. Respondents indicated that they would be more likely to use the memory and post-writing aids than the attention and social cue interpretation aids. Conclusions Findings provide initial support for social-media-specific technology aids to support social media access and social participation for adults with TBI. Results from this study have design implications for future development of evidence-based social media support aids. Future work should develop and deploy such aids and investigate user experience.
Collapse
Affiliation(s)
- Fangyun Zhao
- Department of Computer Sciences, University of Wisconsin-Madison, Madison, WI, United States,Department of Psychology, University of Wisconsin-Madison, Madison, WI, United States
| | - Hajin Lim
- Department of Computer Sciences, University of Wisconsin-Madison, Madison, WI, United States
| | - Emily L. Morrow
- Department of Hearing & Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Lyn S. Turkstra
- School of Rehabilitation Science, McMaster University, Hamilton, ON, United States
| | - Melissa C. Duff
- Department of Hearing & Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, United States,Correspondence: Melissa Duff
| | - Bilge Mutlu
- Department of Computer Sciences, University of Wisconsin-Madison, Madison, WI, United States
| |
Collapse
|
4
|
Kumar RG, Esterov D, Adams RS, Corrigan JD, Juengst SB, Chiaravalloti ND, Yew B, Dreer LE, Dams-O’Connor K. Changes in alcohol use and mood during the COVID-19 pandemic among individuals with traumatic brain injury: A difference-in-difference study. PLoS One 2022; 17:e0266422. [PMID: 35390043 PMCID: PMC8989351 DOI: 10.1371/journal.pone.0266422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 03/18/2022] [Indexed: 12/03/2022] Open
Abstract
Objective To evaluate the impact of COVID-19 pandemic exposure on changes in alcohol use and mood from years 1 to 2 after traumatic brain injury (TBI). Methods We used a difference-in-difference (DiD) study design to analyze data from 1,059 individuals with moderate-to-severe TBI enrolled in the TBI Model Systems (TBIMS) National Database. We defined COVID-19 pandemic exposure as participants who received their year 1 post-injury interviews prior to January 1, 2020, and their year 2 interview between April 1, 2020 and January 15, 2021. Pandemic-unexposed participants had both year 1 and 2 follow-up interviews before January 1, 2020. We measured current alcohol use as any past month alcohol use, average number of drinks per drinking occasion, and past month binge drinking. We measured depression symptoms using Patient Health Questionnaire-9, and anxiety symptoms using the Generalized Anxiety Disorder-7. Results We found persons with TBI exposed to the pandemic had greater increases in the average number of drinks per occasion from year 1 to 2 post-injury compared to pandemic-unexposed individuals (β = 0.36, 95% CI: 0.16, 0.57, p = 0.001), with males, adults <65 years old, and Black and Hispanic subgroups showing the greatest increases in consumption. Though average consumption was elevated, changes in rates of any alcohol use or binge drinking by pandemic exposure were not observed. Overall, there were no significant changes in depressive and anxiety symptoms over time between pandemic exposed and unexposed groups; however, pandemic-exposed Hispanics with TBI reported significant increases in anxiety symptoms from year-1 to year-2 post-injury compared to pandemic-unexposed Hispanics (β = 2.35, 95% CI: 0.25, 4.47, p = 0.028). Conclusion Among persons living with TBI, those exposed to the pandemic had significant increases in average alcohol consumption. Pandemic-exposed Hispanics with TBI had large elevations in anxiety symptoms, perhaps reflecting health inequities exacerbated by the pandemic, and suggesting a need for targeted monitoring of psychosocial distress.
Collapse
Affiliation(s)
- Raj G. Kumar
- Department of Rehabilitation & Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
- * E-mail:
| | - Dmitry Esterov
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, United States of America
| | - Rachel Sayko Adams
- Institute for Behavioral Health, The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts, United States of America
- VHA Rocky Mountain Mental Illness Research Education and Clinical Center, Aurora, Colorado, United States of America
| | - John D. Corrigan
- Department of Physical Medicine and Rehabilitation, The Ohio State University, Columbus, OH, United States of America
| | - Shannon B. Juengst
- TIRR Memorial Hermann, Houston TX, United States of America
- Department of Physical Medicine & Rehabilitation, UT Southwestern, Dallas, TX, United States of America
| | - Nancy D. Chiaravalloti
- Kessler Foundation, East Hanover, NJ, United States of America
- Department of Physical Medicine and Rehabilitation, Rutgers University/The State University of New Jersey, New Brunswick, NJ, United States of America
| | - Belinda Yew
- Department of Rehabilitation & Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Laura E. Dreer
- Department of Ophthalmology & Visual Sciences, University of Alabama at Birmingham, Birmingham, AL, United States of America
- Department of Physical Medicine & Rehabilitation, University of Alabama at Birmingham, Birmingham, AL, United States of America
| | - Kristen Dams-O’Connor
- Department of Rehabilitation & Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| |
Collapse
|
5
|
Brunner M, Hemsley B, Togher L, Dann S, Palmer S. Social Media and People With Traumatic Brain Injury: A Metasynthesis of Research Informing a Framework for Rehabilitation Clinical Practice, Policy, and Training. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:19-33. [PMID: 33332986 DOI: 10.1044/2020_ajslp-20-00211] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose The aim of the study was to investigate the experiences of people with traumatic brain injury (TBI) and rehabilitation professionals in use of social media after TBI. Design Metasynthesis of a multilevel mixed-methods research design was used in the study. Method A qualitative metasynthesis of (a) evidence in the literature regarding the use of communication technologies and social media after TBI, (b) Twitter data and network analysis, (c) interviews with people with TBI (n = 13), (d) focus groups with TBI rehabilitation professionals (n = 11), and (e) a review of current guidance on safe use of social media was conducted. Results People with TBI adopt a trial-and-error approach to using social media. Their meaningful use and a sense of connection enable them to develop social media mastery. TBI rehabilitation professionals' concerns regarding potential risks associated with using social media might lead them to restrict social media use during rehabilitation. Conclusions Access to proactive training in social media use and a supportive network of rehabilitation professionals, family, and friends can enable people with TBI to develop social media mastery through working collaboratively on social media goals. This metasynthesis of research culminates in an evidence-based protocol for assessing and supporting a person with TBI's social media goals to guide clinical practice and future research in the field.
Collapse
Affiliation(s)
- Melissa Brunner
- Department of Speech Pathology, Graduate School of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
- Department of Speech Pathology, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Bronwyn Hemsley
- Department of Speech Pathology, Graduate School of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
- Faculty of Education and Arts, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Leanne Togher
- Department of Speech Pathology, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Stephen Dann
- College of Business and Economics, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Stuart Palmer
- Melbourne Centre for the Study of Higher Education, The University of Melbourne, Victoria, Australia
- WorkSafe Victoria, Geelong, Australia
| |
Collapse
|