Year, Volume, Issue, Page(s):12, 26, 11, 1328-1337
Study examined the course of changes in function and need for assistance in the chronic stages of traumatic brain injury (TBI) and identified factors associated with these changes. Subjects included 478 individuals with TBI who were enrolled in the TBI Model Systems National Database and prospectively followed for at least 10 years. The primary measures for functional outcome were select components of the Functional Independence Measure (FIM), select components of Disability Rating Scale (DRS), the Supervision Rating Scale (SRS), and the Glasgow Outcome Scale (GOS). Demographic and pre-morbid variables included gender, race, age, education, duration of posttraumatic amnesia, time to follow-commands, seizures, substance use, residence, and primary person living with at the time of injury. Significant between-group differences were found based on age for FIM toileting, bladder, bowel, toilet transfers, locomotion, problem-solving and memory; SRS; DRS level of functioning, employability and total; and GOS. With regard to functional independence, there were significant differences by age category for all FIM components except memory. Significant differences were noted for age category and level of dependence as measured by the DRS and GOS. Supervision needs significantly increased as a function of age. Significant differences were found for diminished function over time. Significant differences were noted for residence at 10 years post-injury. Results indicate that for individuals who survive to 10 years post-TBI, age is a major factor in requiring assistance of another person for supervision as well as assistance in basic self-care, continence, and mobility.