Background
Methods
Study eligibility criteria
Information sources
Study selection
Quality assessment of individual studies
Results
Study selection
Study characteristics
Geographical location, level of care, and study design
Author (year) | Geographical location and level of care | Study design | # of TBI participants (n) Mean age (SD) | Males (n, %) | Seniors > 65 (n, %) | Quality of life measure | Quality Assessment Score/18 |
---|---|---|---|---|---|---|---|
Azouvi et al. (2016) [24] | Paris, France, Hospital and Community | Prospective cohort | 85 42 (20) | 69, 81.18% | 9, 10.59% | QOLIBRI | 12 |
Brown et al. (2004) [25] | New York, USA Community | Cross sectional | 200 38.2 (16.0) | 147, 55% | 24 (range 60–99) 5.29% | Flanagan QOL Scale | 13 |
Cnossen et al. (2017) [26] | Netherlands (NH); China (CH) Hospital | Prospective cohort (NH); Retrospective Cohort (CH) | NH: 447 46 (27-58) CH: 173 35 (24-50) | NH: 286, 64% CH: 116, 67% | NH: 63, 14.1% CH: 15, 8.7% | SF-36 | 13 |
Grieve et al.(2016) [27] | UK Hospital (Critical Care) | Cohort | 3512 One mean NR | 2687, 76.51% | 86, 2.45% (70 +) | EQ-5D | 11 |
Haller et al. (2016) [28] | Switzerland Hospital | Prospective cohort | 351 Older group 74 (70–80) | 257, 73.22% | 97, 27.64% | SF-12 | 14 |
Horner et al. (2005) [29] | South Carolina, USA Community | Cross sectional | 1606 NR | 983, 61.20% | 292, 18.2% | SF-36 | 16 |
Horner et al. (2008) [30] | South Carolina, USA Community | Cross sectional | 1560 NR | 953, 61.09% | 287, 18.40% | SF-36 | 17 |
Kristman et al. (2016) [31] | Thunder Bay and Kingston, Canada Hospital (ED) | Prospective cohort | 46 76.2 (7.4) | 19, 41.30% | 46, 100% | SF-12 | 17 |
Lin et al. (2016) [32] | Taipei, Taiwan Hospital and Community | Cohort (subset of survey data) | 333 75.8 (8.4) | 169, 50.8% | 333 (range 60–99), 100% | QOLIBRI and WHO-QOL BREF | 7 |
Mar et al. (2011) [33] | Basque Country and Navarre, Spain Hospital | Cross sectional | 68 NR | 37, 54% | 48,70.6% | SF-36 and EQ-5D | 14 |
Matuseviciene et al. (2016) [22] | Sweden Hospital (ED) | Randomized Control Trial | 173 Single mean NR | 78, 45.09% | 14, 8.09% | SF-36 | 19* total possible score of 28 |
McCarthy et al. (2006) [34] | South Carolina, USA Hospital | Retrospective cohort | 7612(weighted) 43.2 (20.0) | 4865, 63.9%a | 2272, 29.85%a (range 55–75 +) | SF-36 | 15 |
Muehlan et al. (2016) [35] | Germany Community | Cross sectional | 795 NR | NR | 27, 3.40% | QOLIBRI-OS | 10 |
Pickelsmier et al. (2006) [36] | South Carolina, USA Community | Prospective cohort | 2118 NR | 1284, 60.6% | 500, 23.61% | SF-36 | 17 |
Selassie et al. (2009) [37] | South Carolina, USA Community | Cross sectional | 2118 NR | 1284, 60.6% | 500, 23.61% | SF-36 and SIP | 12 |
Stambrook et al. (1993) [38] | Manitoba, Canada Hospital | Cohort | 106 Single mean NR | 106, 100% | 12 (11.3%) | Sickness Impact Profile (SIP) | 11 |
Thompson et al. (2012) [39] | 14 states, USA Community | Prospective cohort | 414 NR | 246, 59.3% | 309, 74.64% | SF-36 | 16 |
Toman et al. (2017) [40] | Birmingham, UK Community | Cross sectional | 124 NR | 95, 76.61% | 17, 13.71% | QOLIBRI | 11 |
Toyinbo et al. (2016) [41] | Florida, USA Community | Cross sectional | 485 35.0 (10.6) | 454, 93.61% | 9, 1.86% | NeuroQOL | 8 |
Weber et al. (2015) [42] | Brazil Community | Prospective cohort | 50 NR | 44, 88% | 5 (range 66-85), 10% | WHO-QOL BREF | 9 |
Older adult study participants
Identification of Qol measures
QoL measure G-General or S-Specific | Number of dimensions (# of items) | Dimension categories | Psychometric properties | Feasibility in older adult population with TBI |
---|---|---|---|---|
SF-36 (G) SF-12 (G) | 8 + 2 (36) 2 subscales (12) | Physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional, mental health Abbreviated version of SF-36 | Validity: + content validity in TBI population(g) Reliability: + inter-item correlation in TBI population [45] Validity + [46] Reliability: + [46] | More sensitive to capture difficulties of older adults with mild TBI as compared to those with moderate or severe TBI. Effects of depression may not be captured. Validated for TBI populations but mainly in studies with younger populations[45] International use: English and multiple other languages available [44] Cost: Manual and licensing fees [44] Administration: self, interviewer [44] Estimated completion time: < 10 minutes [44] Response options: binary and Likert options [44] |
WHO-QoL BREF (G) | 4 domains (26) | Physical, psychological, social, environment | Validity: + correlation with psychological well-being, social relationships, and physical capacity domains [47] Telephone mode has not been validated Reliability: + test–retest reliability in people with TBI, + test–retest with environment, social relationships, and physical and psychological domains [47] | Assessment in context of an individual’s culture, value system, personal goals, standards, and concerns. Used to measure recovery in the first year after TBI so has demonstrated to be sensitive to changes associated with rehabilitation including social support and depression [47]. Questions on employment may be seen as a sensitive question by some older adults who are retired High level of missing values for Q21 could be reflective of the sensitive nature of the question (How satisfied are you you’re your sex life)? [47] This measure is unique as it includes environment as a domain. This is important to the older adult as transportation, surroundings, the natural environment and can be environmental barriers that impact older adults with TBI International use: English and multiple other languages available [44] Cost: free [44] Administration: self, interviewer [44] Estimated completion time: < 10 minutes [44] Response options: Likert [44] |
Quality of Life after Brain Injury (QOLIBRI) and Quality of Life after Brain Injury Overall Scale (S) QOLIBRI-OS (S) | 6 domains (37) 6 domains (6) | Cognition, self, daily life and autonomy, social relationships, emotions, physical problems Abbreviated version of QOLIBRI | Reliability: + internal consistency + test–retest Abbreviated version has 1 question for each domain, may reduce validity and reliability [48] | First Qol tool specifically developed for person with TBI. Involves Qol and function measures and is seen as a more sensitive measure for clinical trials. Missing questions about whether the older person with TBI is bothered by seizures, legal issues, ability to drive, stigma, and sleeping problems [50] International use: English and multiple other languages available [49] Cost: free [49] Administration: self [49] Estimated completion time: < 10 minutes [49] Response options: Likert [49] |
EuroQoL (EQ-5D) (G) | 5 domains (15) | Mobility, self-care, usual activities, pain/discomfort, anxiety/depression | Standard measure of health for clinical and economic appraisal. Vertical visual analogue scale reflects patient’s own judgment of their Qol, which is easy to complete and interpret. Standard data sets available for comparison by country but not by older adult age [52] International use: English and multiple other languages available [44] Cost: Licensing fee [44] Administration: self-reported, observer/proxy/telephone versions available [44] Estimated completion time: < 10 min [44] Response options: check boxes, visual analogue scales [44] | |
Sickness Impact Profile (SIP) (G) | 12 (136) | Behavior, life participation, mental health ,social relationships :sleep and rest, emotional behavior, body care and movement, home management, mobility, social interaction, ambulation, alertness behavior, communication, work, recreation and pastimes, eating | Validity: + construct in TBI population [55] | Normative data available for TBI ; however, mean age of study population was young (32 years, SD 13.1) [57] SIP has been used largely in those with moderate to severe TBI. [55] International use: English version only [54] Cost: Free [54] Administration: self, interview [54] Estimated completion time: 20–30 minutes [54] Response options: yes/no, check boxes [54] |
The Flanagan Quality of Life Scale (QOLS) (G) | 6 domains (16) | Physical and material well-being, relationships with other people, social community and civic activities, personal development and fulfillment, recreation, independence | Validity : − [59] Reliability: + internal consistency, + test–retest [59] | Developed in the 1970s for use with chronic illness groups. Developed with senior citizens in mind. This measures in largely cognitive based and fails to tap into the emotional domain [59] International use: English and multiple other languages available [58] Cost: Free; must contact copyright owner to use [58] Administration: self [58] Estimated completion time: < 10 minutes [58] Response options: 7-point Likert scale [58] |
NeuroQoL | 16 domains (564) | Physical, emotional, cognitive and social patient function | Measure can be used for adults and children; however, this may not take into consideration the unique challenges of an older adult. NeuroQol considered at item bank in which the assessment is individually tailored based on responses to previous items. Limited use if measures across groups are not the same so difficult to do a comparison across neurological patient groups [61] International use: English and multiple other languages available [62] Cost: Free [62] Administration: self, interviewer [62] Estimated completion time: < 10 minutes [62] Response options: Likert scale [62] |
TBI severity and Qol measure
Qol tool administration
Qualities of instruments and studies
1 | 2 | 3 | 5 | 6 | 7 | 9 | 10 | 11 | 12 | 16 | 17 | 18 | 20 | 25 | 26 | 27 | Total | |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Azouvi et al. [24] | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 0 | 0 | 1 | 1 | 1 | 1 | 1 | 0 | 1 | 0 | 12 |
Brown et al. [25] | 1 | 1 | 1 | 2 | 1 | 1 | 0 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 1 | 0 | 0 | 13 |
Cnossen et al. [26] | 1 | 1 | 1 | 0 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 0 | 13 |
Grieve et al. [27] | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 0 | 1 | 0 | 1 | 1 | 1 | 1 | 0 | 0 | 0 | 11 |
Haller et al. [28] | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 1 | 1 | 1 | 1 | 1 | 0 | 0 | 1 | 14 |
Horner et al. [29] | 1 | 1 | 1 | 2 | 1 | 1 | 1 | 1 | 0 | 1 | 1 | 1 | 1 | 1 | 0 | 1 | 1 | 16 |
Horner et al. [30] | 1 | 1 | 1 | 2 | 1 | 1 | 1 | 0 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 17 |
Kristman et al. [31] | 1 | 1 | 1 | 2 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 1 | 1 | 17 |
Lin et al. [32] | 0 | 1 | 1 | 0 | 0 | 0 | 0 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 0 | 0 | 7 |
Mar et al. [33] | 1 | 1 | 1 | 2 | 1 | 1 | 1 | 0 | 1 | 1 | 1 | 0 | 1 | 1 | 1 | 0 | 0 | 14 |
McCarthy et al. [34] | 1 | 1 | 1 | 2 | 1 | 1 | 1 | 0 | 0 | 1 | 1 | 0 | 1 | 1 | 1 | 1 | 1 | 15 |
Muehlan et al. [35] | 1 | 1 | 1 | 0 | 1 | 0 | 0 | 1 | 1 | 0 | 1 | 0 | 1 | 1 | 0 | 0 | 1 | 10 |
Pickelsimer et al. [36] | 1 | 1 | 1 | 2 | 1 | 1 | 1 | 0 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 17 |
Selassie et al. [37] | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 1 | 1 | 0 | 0 | 0 | 12 |
Stambrook et al. [38] | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 0 | 0 | 1 | 0 | 1 | 1 | 1 | 0 | 0 | 11 |
Thompson et al. [39] | 1 | 1 | 1 | 2 | 1 | 1 | 0 | 1 | 1 | 1 | 1 | 0 | 1 | 1 | 1 | 1 | 1 | 16 |
Toman et al. [40] | 1 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 0 | 1 | 1 | 1 | 0 | 0 | 11 |
Toyinbo et al. [41] | 1 | 1 | 1 | 0 | 1 | 0 | 0 | 0 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 0 | 0 | 8 |
Weber et al. [42] | 1 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 0 | 0 | 1 | 0 | 1 | 1 | 0 | 0 | 0 | 9 |
1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 | 14 | 15 | 16 | 17 | 18 | 19 | 20 | 21 | 22 | 23 | 24 | 25 | 26 | 27 | Total | |
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Matuseviciene et al. [22]a | 1 | 1 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 0 | 0 | 0 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 0 | 1 | 1 | 19 |