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Cognitive and Behavioral Sequelae of Closed Head Injury in Older Adults According to Their Significant Others

Received December 8, 1997; revised March 6, 1998; accepted April 24, 1998. From the Department of Neurology, Emory University School of Medicine and Wesley Woods Center, Atlanta, Georgia; the Departments of Physical Medicine and Rehabilitation and Psychiatry, Baylor College of Medicine, Houston, Texas; and the Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, Maryland. Address correspondence to Dr. Goldstein, Department of Neurology, Wesley Woods Health Center, 1841 Clifton Road, N.E., Atlanta, GA 30329.

This study examined the neurobehavioral effects of closed head injury (CHI) in older adults according to their significant others. Informants of 17 mild and moderate CHI patients 50 years old when injured completed the Geriatric Evaluation of Relative's Rating Instrument, a questionnaire inquiring about the patient's cognition, affect, interpersonal relations, and daily activities. The significant others provided retrospective ratings of preinjury functioning and completed the same instrument an average of 4 and 13 months postinjury. The significant others of 10 community-residing, normal control subjects completed the questionnaire at comparable intervals between each rating. Compared with their preinjury functioning, and unlike the control subjects, patients showed declines in cognition and mood. The possible impact of these changes, including their effect on subjective burden in caregivers, is discussed.

Key Words: Traumatic Brain Injury • Geriatric Neuropsychiatry • Caregivers

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