Increasing incidence of ED-visits and admissions due to traumatic brain injury among elderly patients in the Netherlands, 2011-2020.

BACKGROUND AND IMPORTANCE: Traumatic brain injury (TBI) is a leading cause of disability and mortality worldwide. Nowadays the highest combined incidence of TBI-related emergency department (ED) visits, hospitalizations and deaths occurs in older adults. Knowledge of the changing patterns of epidemiology is essential to identify targets to enhance prevention and management of TBI. OBJECTIVE: To examine time trends of ED visits, admissions, and mortality for TBI comparing non-elderly and elderly people (aged ≥ 65 years) in the Netherlands from 2011 to 2020. DESIGN: We conducted a retrospective observational, longitudinal study of TBI using data from the Dutch Injury Surveillance System (DISS) and Statistics Netherlands from 2011 to 2020. OUTCOME MEASURE AND ANALYSIS: The main outcome measures were TBI-related ED visits, hospitalizations, and mortality. Temporal trends in population-based incidence rates were evaluated using Poisson regression. We compared patients under 65 years and patients aged 65 years or older. MAIN RESULTS: From 2011 to 2020, absolute numbers of TBI related ED visits increased by 244%, and hospital admissions and mortality showed an almost twofold increase in patients aged 65 years and older. The incidence of TBI-related ED visits and hospital admission increased also in elderly adults, with 156% and 51% respectively, whereas the mortality remained stable. In contrast, overall rates of ED visits, admissions, and mortality, and causes for TBI did not change in patients younger than 65 years during the study period. CONCLUSION: This trend analysis shows a significant increase of ED-visits and hospital admission for TBI in elderly adults from 2011 to 2020, whereas the mortality remained stable. This increase cannot be explained by the aging of the Dutch population alone, but might be related to comorbidities, causes of injury, and referral policy. These findings strengthen the development of strategies to prevent TBI and improve the organization of acute care necessary to reduce the impact and burden of TBI in elderly adults and on healthcare and society.

Mood Variability Among Early Adolescents in Times of Social Constraints: A Daily Diary Study During the COVID-19 Pandemic.

The COVID-19 pandemic and associated governmental regulations have drastically changed the daily social lives of children, adolescents, and adults. Changes in the social context may particularly affect children who are in the transition to adolescents (henceforth referred to as early adolescents) as adolescence is a crucial period for peer interactions and development of independence and autonomy. Yet, the impact of the pandemic and associated governmental regulations on early adolescents' emotional well-being has yet to be clarified. In the current study, we explored daily fluctuations in mood in 54 early adolescents (M age = 11.07) during the first few months (April 2020-June 2020) of the COVID-19 pandemic. Moreover, the role of parents and peers on adolescents' mood variability was investigated. Adolescents rated their mood (i.e., happiness, anger, sadness, anxiety) and peer interactions once a day during four separate weeks across different weeks of containment measures in the Netherlands. Moreover, adolescents reported on their experienced attachment to parents and peers and internalizing problems during baseline and the final measurement, respectively. Results showed relatively stable levels of mood during the first few months of the COVID-19 pandemic. However, individual differences in mood variability during the first assessment week were negatively associated with the experienced level of attachment to both parents and peers. Moreover, heightened levels of mood variability did not mediate the link between attachment and internalizing problems. Lastly, the quality of offline contact, but not online contact, was negatively related to adolescents' mood variability. Overall, this study suggests that mood of early adolescents did not heavily fluctuated across the first few months of the COVID-19 pandemic. Our findings add to the growing body of literature aiming to understand how adolescent's life are affected by the COVID-19 crisis and illustrates that social connectedness to parents or peers may facilitate resilience to distress and daily mood fluctuation in early adolescents.

Associations between peer attachment and neural correlates of risk processing across adolescence.

Adolescence is a period of increased risk-taking behavior where individual differences in risk taking may relate to both adverse and positive experiences with peers. Yet, knowledge on how risk processing develops in the adolescent brain and whether this development is related to peer attachment is limited. In this longitudinal functional magnetic resonance imaging (fMRI) study, we collected data from 167 adolescents (53% male) followed for four annual assessments across ages 13-17 years. At each assessment, participants completed a lottery choice task to assess neural risk processing and reported on their perceived attachment to peers and parents. Behaviorally, risk-preference on the lottery choice task decreased linearly with age. Neural activation during risk processing was consistently found in the insula and dACC across the four assessments and increased linearly from ages 13-17 years. Furthermore, higher peer attachment was related to greater right insula risk processing for males but not for females, even after controlling for parental attachment. The magnitudes of this association did not change with age. Findings demonstrate that neural risk processing shows maturation across adolescence and high peer attachment may be associated with low risk taking by heightening neural sensitivity to potential risks for male adolescents.

Heightened neural sensitivity to social exclusion in boys with a history of low peer preference during primary school.

Peer preference among classmates is a highly influential factor in children's social development and not being preferred by peers has long-term consequences for children's developmental outcomes. However, little is known about how a history of low peer preference during primary school is associated with neural responses to a new social exclusion experience in childhood. In this functional magnetic resonance imaging (fMRI) study, we examined self-reported social distress and neural responses to social exclusion using the Cyberball paradigm in primary school boys (Mage = 10.40 years) with a history of low (n = 27) versus high peer preference (n = 28). Boys were selected from a longitudinal classroom-based study in which children's peer social preferences were assessed in three consecutive years prior to this study. Neuroimaging results showed that low peer preferred boys exhibited increased activation in the bilateral dorsolateral prefrontal cortex and right supramarginal gyrus during social exclusion as compared to high peer preferred boys. Increased neural activity was not accompanied by higher self-reported levels of social distress during social exclusion in low versus high peer preferred boys. Findings of this study may provide insight into the neural processes associated with real-life peer experiences in children attending primary school.