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Lifetime history of traumatic brain injury is associated with increased loneliness in adults: A US nationally representative study
Author(s) -
Kumar Raj G.,
Ornstein Katherine A.,
BollensLund Evan,
Watson Eric M.,
Ankuda Claire K.,
Kelley Amy S.,
DamsO'Connor Kristen
Publication year - 2020
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.5271
Subject(s) - loneliness , ucla loneliness scale , population , clinical psychology , medicine , psychology , gerontology , depression (economics) , poison control , traumatic brain injury , psychiatry , medical emergency , environmental health , economics , macroeconomics
Background/Objectives 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. Methods/Design 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. Results 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. Conclusions 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.