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Lifetime history of traumatic brain injury is associated with increased loneliness in adults: A US nationally representative study.

Authors
  • Kumar, Raj G1
  • Ornstein, Katherine A2
  • Bollens-Lund, Evan2
  • Watson, Eric M1
  • Ankuda, Claire K2
  • Kelley, Amy S2
  • Dams-O'Connor, Kristen1, 3
  • 1 Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
  • 2 Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
  • 3 Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY.
Type
Published Article
Journal
International journal of geriatric psychiatry
Publication Date
May 01, 2020
Volume
35
Issue
5
Pages
553–563
Identifiers
DOI: 10.1002/gps.5271
PMID: 31994215
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

An estimated 55 million individuals worldwide live with chronic disability associated with traumatic brain injury (TBI), which may include cognitive, behavioral, and social impairments. Reduced participation in social activities is common after TBI; however, few studies have evaluated loneliness among survivors of TBI. The current study aimed to evaluate the association between history of TBI and loneliness and to identify mediators of this association. Retrospective cohort study. Nationally representative sample of N = 724 adults over age 50 years (Health and Retirement Study). Loneliness was evaluated using the 11-item Revised University of California Los Angeles (R-UCLA) Loneliness Scale (range 11-33). Lifetime history of TBI evaluated retrospectively using the Ohio State University TBI Identification Method. We included the following covariates: age, sex, race, and education; and mediators: depressive symptoms, number of comorbidities, chronic pain, difficulty with activities of daily living, and social network index. History of TBI was associated with a 1.28-point (95% CI, 0.46-2.11; P < .05; Cohen's D = 0.284) increase in R-UCLA Loneliness Scale scores after covariate adjustment. Individuals with more recent injuries (within 10 years) and multiple lifetime TBIs reported the highest loneliness scores. In the structural equation model, depressive symptoms partially mediated the relationship between TBI and loneliness. All models were adjusted for US population sampling weights. History of TBI was associated with greater loneliness compared with individuals without TBI in a representative sample of US adults. Managing depressive symptoms and medical consequences of TBI may be a target to ameliorate reporting of loneliness in this population. © 2020 John Wiley & Sons Ltd.

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