Dr. Fazel and colleagues used national registers in Sweden covering 1.1 million individuals born between 1973 and 1985 to determine whether children and adolescents experiencing milder forms of TBI would have significant medical and social problems in adulthood. The researchers identified all those who had sustained at least one traumatic brain injury up to the age of 25 and their unaffected siblings. The data sets used allowed the team "to examine the extent to which injury severity and recurrent injuries predict a range long-term outcomes." The authors wrote about five principal findings.
- First, they found a connection between suffering a mild TBI and a) disability pension; b) psychiatric visits; c) inpatient hospitalization; d) premature mortality; e) low educational attainment; and f) and receipt of welfare benefits. The risk of these outcomes was increased between 18-52%.
- Second, they found that the greater the initial injury the greater the negative outcome. As an example, the percentage of risk for disability pension skyrocketed to 106% compared to uninjured siblings.
- The third finding revealed that recurring TBIs—such as multiple concussions from sports activities—resulted in even worse outcomes
- Fourth, they found the association with those who had TBIs across the indicators showed a 1-6% higher chance of poor adult performance.
- Fifth, which should help direct attention to preventative measures; they found a correlation between the age of the injury and the long-term outcomes. "The older the age at first head injury, and particularly after the age of 15 years, substantially increased the risks of all examined outcomes."
The study provides direction for TBI treatment at different ages of injury. Fazel calls for age-sensitive clinical guidelines and preventive strategies for children and adolescents; guidelines that take into account the long term health and social effects of early TBIs. Even mild TBIs can be considered serious—especially if they are recurring from sports or other activities.
Comment: For further reading on neuroplasticity: