MINNEAPOLIS - People who have had a concussion where they lost consciousness may be more likely to have some disability or limitations later in life--such as difficulty walking or limitations in the amount or type of work they can do--than people who have never had a concussion, according to a study published in the May 26, 2021, online issue of Neurology®, the medical journal of the American Academy of Neurology.
"About 16% of all adults have experienced a concussion with loss of consciousness, and our study found that nearly half of those people are living with disability," said study author Andrea L.C. Schneider, MD, PhD, of the University of Pennsylvania Perelman School of Medicine in Philadelphia and a member of the American Academy of Neurology. "This substantial burden of disability suggests that research into how to better care for and improve the functioning of people with concussions over the long term should be a priority for both public health and for planning for individuals."
The study involved 7,390 people with an average age of 58. People were asked if they had ever had a concussion with loss of consciousness. They were also asked questions about their ability to do daily activities such as eating and dressing, preparing meals and doing household chores, walking up steps and carrying heavy objects. Their grip strength was also tested to check for any disability in their arms. Disability was defined as having "some difficulty" or greater difficulty in an area.
People were also asked whether a physical, mental or emotional problem keeps them from working at a job or limits the kind or amount of work they can do. An answer of "yes" was defined as having a disability in that area.
A total of 16% of people had experienced a concussion with loss of consciousness. Of those, 47% had some disability in at least one area of functioning, compared to 37% of people with no history of concussion.
"This corresponds to 11.4 million people in the United States with a history of concussion with loss of consciousness and disability in at least one area," Schneider said. "And it's possible that this is an underestimation, as the study did not include people in the military, nursing facilities or prisons who may have be more likely to experience concussions and disability."
The study found the area with the greatest amount of disability was in mobility, such as being able to walk up 10 steps or stand up from an armless chair, with 38% experiencing at least some difficulty. About 36% said they had at least some difficulty in general physical activities such as carrying heavy objects or standing for long periods. About 35% of people said they were limited in the amount or type of work they could do.
The results were much the same after researchers adjusted for other factors that could affect disability, such as age, amount of physical activity, high blood pressure, amount of sleep and depression. The only area that did not show a link between concussion and disability was grip strength.
Schneider noted that the study was not designed to show cause and effect. It only shows an association between past concussion with loss of consciousness and disability.
Learn more about concussion at BrainandLife.org, home of the American Academy of Neurology's free patient and caregiver magazine focused on the intersection of neurologic disease and brain health. Follow Brain & Life® on Facebook, Twitter and Instagram.
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The American Academy of Neurology is the world's largest association of neurologists and neuroscience professionals, with over 36,000 members. The AAN is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer's disease, stroke, migraine, multiple sclerosis, concussion, Parkinson's disease and epilepsy.
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