Author ORCID Identifier

Defense Date


Document Type


Degree Name

Doctor of Philosophy


Counseling Psychology

First Advisor

Paul Perrin, PhD


Traumatic brain injury (TBI) incidence rates have been increasing in recent years, with the greatest number of TBIs and the highest morbidity and mortality rates in individuals aged 80 and over. As average life expectancy continues to increase, the older adult population is expected to comprise nearly one-quarter of the U.S. populace by 2060. With the increased risk to a larger proportion of the U.S. population posed by TBI, the aim of the current study was to examine the roles of sociodemographic and injury severity characteristics as predictors of functional independence trajectories across 1, 2, 5, and 10 years after TBI in older adults. The main hierarchical linear modeling (HLM) analyses showed that functional independence trajectories generally decreased over the 10 years after TBI. Individuals who were older, male, underrepresented minorities, had lower education, were unemployed at time of injury, had no history of substance use disorder, or had difficulties with learning, dressing, and going out of the home prior to the TBI, or longer time in posttraumatic amnesia had lower functional independence trajectories across at least one of the functional independence outcomes. Functional independence trajectories were also significantly predicted by interactions between time terms and several of these variables. Attention to the characteristics identified in this study as predictors of functional independence in older adults with TBI may serve patients and care providers when planning treatments, monitoring health over the long term, and ultimately as a way to decrease morbidity and mortality in this older adult population.


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