Age, symptoms, and functional outcome after mild traumatic brain injury

Justin E. Karr, Teemu M. Luoto, Isabelle G. Gilman, Ksenia Berghem, Anna Kerttu Kotilainen, Grant L. Iverson

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Objectives: Previous older adult studies have examined outcome from moderate-to-severe traumatic brain injury (TBI), but fewer have focused on the effects of milder brain injuries. This study examined age-related differences in symptom reporting and whether symptoms are differentially related to functional outcome based on age. Materials & Methods: Patients presenting with a head injury at the Tampere University Hospital emergency department (N = 325, aged 18-100) were evaluated at 1 week post injury on the Modified Rankin Scale and Rivermead Post Concussion Symptoms Questionnaire (RPQ). Results: A quarter of participants had missing RPQ data, with missingness associated with greater age and strongly associated with pre-existing functional impairment, dementia, and/or neurological conditions. Among participants with complete data, participants <65 years old endorsed headaches, noise/light sensitivity, irritability, and frustration/impatience at a greater frequency than participants ≥65 years old. However, no differences were found in the number of symptoms endorsed or the total symptom severity score. The correlations between the severity of symptoms and change in function were similar between the two age groups. Conclusions: Older adults tended to report fewer symptoms, but symptoms had a roughly equivalent relationship with declines in functioning across age groups. A large percentage of older adults in this study had pre-injury dementia or neurological disease that contributed to missing data on the 1-week outcome measures. The results provide insight into the impact of mild spectrum TBI on older adults compared to younger patients.

Original languageEnglish
Pages (from-to)183-190
Number of pages8
JournalActa Neurologica Scandinavica
Issue number2
StatePublished - Feb 1 2020

Bibliographical note

Funding Information:
Teemu Luoto, MD, PhD, has received funding from the Government's Special Financial Transfer tied to academic research in Health Sciences (Finland). Grant Iverson, PhD, has a clinical and consulting practice in forensic neuropsychology involving individuals who have sustained mild TBIs. He has received research funding from several test publishing companies, including ImPACT Applications, Inc, CNS Vital Signs, and Psychological Assessment Resources (PAR, Inc). He has received salary support from the National Football League and the Harvard Integrated Program to Protect and Improve the Health of National Football League Players Association Members. He serves as a scientific advisor for Sway Operations, LLC, Highmark, Inc, and BioDirection, Inc. He acknowledges unrestricted philanthropic support from ImPACT Applications, Inc, the Heinz Family Foundation, and the Mooney‐Reed Charitable Foundation.

Funding Information:
Funding information The study was financially supported by the Finnish State Research Funding and the Finnish Medical Society Duodecim. The authors acknowledge research assistant Anne Simi for her assistance with the patient enrollment and data collection at Tampere University Hospital.

Publisher Copyright:
© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd


  • aged
  • brain concussion
  • head injuries: closed
  • outcome assessment (health care)
  • post-concussion syndrome

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


Dive into the research topics of 'Age, symptoms, and functional outcome after mild traumatic brain injury'. Together they form a unique fingerprint.

Cite this