UCSF

Background. Older adults (age 65+) with traumatic brain injury (TBI) are often underrepresented in TBI research. Additionally, Health-related quality of life (HRQoL) after TBI in older adults is minimally explored. Among all adults with brain injury, there are limited illness-specific wellness programs and psychoeducation resources available post-incident. Existing literature demonstrates that participant wellness programs like yoga and meditation can improve quality of life after brain injury. Methods. This dissertation study includes: 1) a systematic review of the literature evaluating the state of the evidence that measures functional status and HRQoL among older adults who experience a TBI; 2) a data-based paper which investigates the value of co-enrollment with a study partner for improving follow-up completion and evaluates level of agreement between participant and study partner report of functional recovery; 3) a data-based paper on the evaluation of a virtual, 6-week, yoga and meditation Quality Improvement program for adults with TBI, stroke, and their caregivers at a level-1 trauma center. Results. The variability in HRQoL follow-up time points and methodologies among HRQoL measures across the six studies included in the systematic review made it challenging to synthesize HRQoL findings. Chapter 3 demonstrates that research is feasible among medically complex older adults, and the inclusion of a study partner improves longitudinal follow up and functional recovery agreement among all domains was high: 78%-100%. Chapter 4 Quality Improvement program evaluation demonstrates feasibility and acceptability of a virtual yoga and meditation program. Conclusions/Implications. More studies are needed to understand functional status and HRQoL outcomes and their impact on the lives of older adults with a TBI-related disability during the rehabilitation and post-rehabilitation phases. Future research is needed to evaluate efficacy of wellness programs to improve health-related quality of life after brain injuries.