Citation

Grauwmeijer E, Heijenbrok-Kal M, Peppel L, Hartjes C, Haitsma I, de Koning I, Ribbers G. J. Neurotrauma 2018; 35(13): 1543-1551.

Affiliation

Rijndam rehabilitation Center, Rotterdam Neurorehabilitation Research - RoNeRes, Rotterdam, Netherlands ; gribbers@rijndam.nl.

Copyright

(Copyright © 2018, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2017.5404

PMID

29343203

Abstract

The aim of this study was to evaluate cognitive function ten years after moderate-severe TBI and to investigate the associations between cognitive function, depression and Health-Related Quality of Life (HRQoL). In this prospective cohort study, with measurements at 3, 6, 12, 18, 24, 36, and 120 months post-TBI, patients aged 18-67 years (N=113) with moderate-severe TBI were recruited. Main outcome measures were depression (CES-D), subjective cognitive functioning (CFQ), objective cognitive functioning, and HRQoL (SF-36). Fifty of the initial 113 patients completed the ten-year follow-up. Twenty percent showed symptoms of depression (CES-D≥16). These patients had more psychiatric symptoms at hospital discharge (p=.048) and were more often referred to rehabilitation or nursing homes (p=.015) than non-depressed patients. Furthermore, they also had significantly lower scores in 6 of the 8 subdomains of the SF-36. The non-depressed patients had equivalent scores compared with the Dutch norm-population on all subdomains of the SF-36. Cognitive problems at hospital discharge were related with worse cognitive outcome ten years post-TBI, but not with depression or HRQoL. Ten years after moderate-severe TBI, only weak associations (p<0.05) between depression scores and two objective cognitive functioning scores were found. However, there were moderate associations (p<0.01) between depression scores, HRQoL, and subjective cognitive functioning. Therefore, signaling and treatment of depressive symptoms after moderate-severe TBI may be of major importance for optimizing HRQoL in the long-term. We did not find strong evidence for associations between depression and objective cognitive functioning in the long-term post-TBI. Disease awareness and selective drop-out may play a role in long-term follow-up studies in moderate-severe TBI. More long-term research is needed in this field.

Language: en

Keywords

OUTCOME MEASURES; PROSPECTIVE STUDY; REHABILITATION; TRAUMATIC BRAIN INJURY