Primary language as a moderator of social integration and functional independence after traumatic brain injury in U.S. older adults

PURPOSE: This study examined whether primary language moderates the relationship between social integration and functional independence among older adults in the U.S. following traumatic brain injury (TBI). METHODS: A secondary analysis was conducted using data from the Traumatic Brain Injury Model System National Database (TBIMS-NDB), including 1,030 individuals aged 65-88 with mild, moderate, or severe TBI. Of these, 88.3% reported English as their primary language, while 11.7% reported a non-English language. Social integration was assessed using the Participation Assessment with Recombined Tools-Objective, and functional independence was measured via the Functional Independence Measure. Primary language was categorized as English or non-English. Hayes's PROCESS macro was used for moderation analysis. RESULTS: < .01) indicated that the relationship was stronger among non-English speakers. CONCLUSION: Primary language plays a moderating role in the link between social integration and functional independence post-TBI. These findings highlight the need for culturally and linguistically tailored interventions to improve outcomes for older adults with TBI.