Background: This study provides a detailed examination of older Veterans with traumatic brain injury (TBI) and dementia and their caregivers, focusing on Veterans’ demographic, clinical, functional, safety risk, and behavioral characteristics and caregivers’ demographic, clinical, and care-related characteristics and well-being. Methods: Veterans’ caregivers (N = 110) completed a telephone-based survey. Results: Veterans averaged eight comorbid health conditions, with over 60% having chronic pain, hypertension, post-traumatic stress disorder, or depression. Caregivers reported helping with an average of three activities of daily living, with the highest percentages of Veterans needing assistance with grooming, dressing, and bathing. Almost all Veterans needed assistance with shopping, cooking, medication management, housework, laundry, driving, and finances. Veterans averaged two safety risks, the most common being access to dangerous objects, access to a gun, and not being able to respond to emergency situations. Although Veterans averaged 14 behavioral concerns, caregivers reported that their family needs relating to TBI were generally met or partly met, and they voiced confidence in their ability to respond to behaviors and control their upsetting thoughts. Caregivers’ mean burden score was severe, while mean depression and anxiety scores were mild. Caregivers reported an average of 10.5 h per day providing care and 20.1 h per day on duty. Conclusions: The findings demonstrate the increased presence of impairments, safety risks, and behavioral issues in Veterans with comorbid TBI and dementia, as well as increased impacts on families’ burdens and care provision requirements. Clinicians should be alert for and educate TBI patients and caregivers on the warning signs of post-TBI dementia and its associated functional, behavioral, and safety risk profile, as well as challenges related to caregiver well-being. Healthcare policymakers must consider the increased caregiver demands associated with comorbid TBI and dementia, as well as the need for expanded long-term support and services.

We provide an overview of the Clubhouse Model and the history and development of Brain Injury Clubhouses. We describe organizational-level characteristics associated with eight Brain Injury Clubhouses to address gaps in the literature and inform future studies or program development. A electronic survey, the Clubhouse Profile Questionnaire (CPQ) was tailored for Brain Injury Clubhouses. The CPQ gathers program-level data that can be used to identify active ingredients of Clubhouses, understand best practices, examine, and evaluate program characteristics. The brain injury version of the CPQ was administered to a sample of eight Clubhouses affiliated with the International Brain Injury Clubhouse Association as part of a project designed to gather data on Clubhouse program characteristics and describe sociodemographic characteristics of people served by Brain Injury Clubhouses. CPQ data from eight Brain Injury Clubhouses was analyzed. Brain Injury Clubhouse programs in this sample served approximately 17 members per day. There was wide variability in the size, funding and funding mechanisms, and length of operation of Brain Injury Clubhouses in this study. Findings suggest that Brain Injury Clubhouses offer a wide range of services and supports. Additional research on the impact of Brain Injury Clubhouses is needed.

The National Institutes of Health (NIH) reported that the number of people living with permanent disability from brain injury grows annually as medical technology has advanced in life saving techniques. However, community-based programs which enable brain injury survivors to live productive lives throughout the entire course of recovery have not grown proportionately to meet this the need. Brain Injury Clubhouses were developed to address the need for coordinated, long-term, community-based supports for brain survivors in a community-based setting. Brain Injury Clubhouses are designed to improve the lives of persons with ABI and reduce strain on caregivers and healthcare services The information in this research brief is designed to provide funders, administrators, policy makers, and other stakeholders with an overview of Brain Injury Clubhouses. The brief also provides outcomes associated with participation in a Brain Injury Clubhouse from a recent research study to provide stakeholders with a better understanding of Brain Injury Clubhouses.

Objective: To examine whether depressive symptoms at 1 year postinjury are associated with all-cause mortality among individuals with moderate-to-severe traumatic brain injury (TBI) who received inpatient rehabilitation, accounting for sociodemographic, functional, and mental health factors. Setting: Community. Participants: A total of 2812 individuals enrolled in the TBI Model Systems National Database with 1-year postinjury follow-up interviews between October 1, 2007, and October 1, 2013, and a follow-up within 5 years of injury. Design: Prospective cohort study, using secondary analysis of longitudinal data. Main Measures: Depression (Patient Health Questionnaire-9) and all-cause mortality. Results: The rate of high depressive symptom burden at 1-year follow-up was 28.5%, and the overall death rate was 8.8% across the study follow-up period. In age-adjusted models, higher depressive symptom burden at 1 year was associated with increased mortality risk; however, this association was progressively attenuated after adjustment for functional status and preinjury mental health variables and was no longer statistically significant in fully adjusted models. Sensitivity analyses using multiple imputation yielded similar results. Conclusion: Findings suggest that depressive symptom burden at 1 year postinjury is not independently associated with 5-year mortality after accounting for functional status and preinjury mental health history. Depression may, nonetheless, function as a clinically meaningful marker of broader vulnerability. Further research is warranted to explore whether targeting depression and functional recovery influence long-term survival after TBI.