Research Reports - Predictors for depressive mood in geriatric patients after traumatic brain injury

Ann Rehabil Med. 2017 Apr;41(2):279-289. doi: 10.5535/arm.2017.41.2.279. Epub
2017 Apr 27.

Kim JK(1), Kim NY(1), Kim YW(1).

OBJECTIVE: To identify predictors for depressive mood in geriatric patients after
traumatic brain injury (TBI).
METHODS: A retrospective review of patients' medical charts was performed in TBI
patients who were older than 60 years and referred to the Department of
Rehabilitation Medicine at Severance Hospital in 2002-2016. The patients were
classified into two groups based on the Geriatric Depression Scale (GDS):
non-depressive group (0≤GDS≤16) and depressive group (17≤GDS≤30). Data was
collected on demographic, socioeconomic, comorbidities, and trauma-related
factors, as well as the pathophysiology of TBI, localization of lesion,
post-traumatic complications, functional level, and cognitive and linguistic
function. Significant variables from univariate analysis were analyzed using
logistic regression.
RESULTS: Forty-two patients were included, of whom 64.3% displayed a depressive
mood. Patients in the depressive group had higher comorbidity scores (p=0.03),
lower Functional Independence Measure (FIM) totals (p=0.03) and FIM motor
(p=0.03) scores, higher modified Rankin Scale scores (p=0.04), and frequently had
a bilateral or left side brain lesion (p=0.002). Higher comorbidity scores (odds
ratio [OR], 1.764; 95% confidence interval [CI], 1.047-2.971), bilateral lesions
(OR, 13.078; 95% CI, 1.786-95.780), and left side lesions (OR, 46.074; 95% CI,
3.175-668.502) were independently associated with a depressive mood in the
multiple logistic regression analysis.
CONCLUSION: The risk of depressive mood in geriatric patients after TBI is
associated with comorbidity, functional limitation, and the horizontal
distribution of brain lesions. The most significant determining factors were
comorbidity and the horizontal distribution of brain lesions. Early detection of
risk factors is important to prevent and manage depressive mood in geriatric
patients after TBI. 

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