Comparison of multidomain assessment outcomes between older and middle-aged adults following concussion.

OBJECTIVE

This article's objective was to compare demographic/medical history and multidomain clinical assessment outcomes between older and middle-aged adults following concussion.

METHOD: Seventy-six patients aged 50-80 years within 12 months of a concussion from a specialty clinic between October 2021 and August 2023 participated in the study. Participants were grouped into older (≥60 years) and middle-aged (50-59 years) adults. At their first clinic visit, participants completed multidomain clinical assessments comprising symptoms, cognitive, vestibular/ocular motor, psychological health, and quality of life domains.

RESULTS

Older adults (n = 35) had less females (40.0% vs. 68.3%, p = .01), anxiety history (17.1% vs. 39.0%, p = .036), and employed individuals (57.1% vs. 82.9%, p = .002) than middle-aged adults (n = 41). Older adults had better Neuro-Quality of Life, F(1, 71) = 6.8, p = .01, ηp² = 0.09; Repeatable Battery for the Assessment of Neuropsychological Status recall, F(1, 71) = 12.6, p < .001, ηp² = 0.15; fluency, F(1, 71) = 5.7, p = .02, ηp² = 0.08; list recall, F(1, 69) = 5.2, p = .03, ηp² = 0.07; and list recognition, F(1, 69) = 5.3, p = .03, ηp² = 0.07, when controlling for sex, anxiety history, and employment status. Older adults also had lower odds of being impaired to borderline on Immediate Post-Concussion Assessment and Cognitive Testing verbal memory (OR = 0.05, 95% CI [0.01, 0.56], p = .01), visual motor speed (OR = 0.08, 95% CI [0.01, 0.73], p = .03), and reaction time (OR = 0.21, 95% CI [0.05, 0.89], p = .03), and lower odds of having moderate to severe impairment on Neuro-Quality of Life (OR = 0.32, 95% CI [0.11, 0.97], p = .04) than middle-aged adults.

CONCLUSIONS

Older adults (≥60 years) exhibited fewer subjective cognitive difficulties and objective cognitive impairments compared to middle-aged adults (50-59 years) following concussion. There were no differences between groups in symptoms, vestibular/ocular motor functioning, or psychological health. Clinicians should consider these findings when evaluating and interpreting outcomes from older and middle-aged adults following concussion. (PsycInfo Database Record (c) 2025 APA, all rights reserved).