Cognitive performance in older people after mild traumatic brain injury: Trauma effects and other risk factors

Abstract

Objective: Cognitive symptoms are common in the initial weeks after mTBI, but recovery is generally expected within three months. However, there is limited information about recovery specifically in older age cohorts. Therefore, this study investigated cognitive outcome three months after mTBI in older adults (≥ 65 years) compared to trauma and community age-matched controls and explored risk factors for outcome after traumatic injury. Methods: Older mTBI patients (n = 40) and older adults with mild traumatic injury but without head injury (n = 66) were compared to a noninjured community control group (n = 47). Cognitive assessment included neuropsychological and computerized tests. Group differences were compared on individual tasks and overall cognitive performances using composite scores. Regression analyses identified predictors of outcome for trauma patients and moderator analyses explored possible interactions of mTBI severity with age and cognition. Results: As well as lower performances in processing speed and memory, both trauma groups had significantly lower performance on composite neuropsychological (d = .557 and .670) and computerized tasks (d = .783 and .824) compared to noninjured controls. Age, education, and history of depression were direct predictors of cognitive performance after mild traumatic injury (with or without head injury). Further moderation analysis demonstrated that mTBI severity (Glasgow Coma Scale < 15) moderated the impact of older age on computerized assessment (β = -.138). Conclusions: Three months after mild trauma (regardless of head injury), older people demonstrate lower cognition compared to noninjured peers. However, severity of mTBI (Glasgow Coma Scale < 15) can interact with older age to predict poorer cognitive outcomes.

Mild Traumatic Brain Injury and Functional Outcome in Older Adults: Pain Interference But Not Cognition Mediates the Relationship Between Traumatic Injury and Functional Difficulties

“…Data were obtained in compliance with institutional/national research standards for human research and the Helsinki Declaration. This study was part of a larger project investigating recovery after mTBI in older adults, some of which has been reported elsewhere 20…”

“…This study was part of a larger project investigating recovery after mTBI in older adults, some of which has been reported elsewhere. 20 All participants were 65 years or older and resided within 3 hours of The Alfred Hospital, Melbourne, inclusion criteria for all participants included English fluency and functional independence prior to injury, (ie, independence at home). General exclusion criteria for all participants included (i) diagnosed life-threatening medical illness (eg, current cancer diagnosis requiring treatment), (ii) conditions known to affect cognition (eg, Alzheimer's disease), (iii) serious psychiatric illness (eg, chronic schizophrenia), and (iv) hospitalization for a previous significant head injury.…”

“…Cognition was measured using several neuropsychological tests sensitive to acute symptoms following mTBI 30 (ie, tasks involving processing speed, executive function, and memory) and was described in detail in a previous report. 20 Tests included the WAIS-IV Coding subtest, 31 Trail Making Test, 32 Colour-Word Interference Task, 33 and Hopkins Verbal Learning Test-Revised. 34 Copyright © 2022 Wolters Kluwer Health, Inc.…”

Response to “Serious Flaws Challenge the Conclusions in a Revision of a Retracted Meta-Analysis”

“…We chose the latter and stand by this a priori decision. We are, however, open to alternate approaches and in fact have conducted meta-analyses that do use effect sizes that control for covariates (e.g., (6–8)). The main thing from our point of view is that the researcher is transparent in reporting their methods.…”

Effects of Cognitive Training in Flanker Task on Mobility of Older Adults: A Randomized Controlled Trail

“…Our inclusion criteria were as follows: (1) over 55 years of age; (2) ambulatory without any assistive devices; (3) normal or correctedto-normal vision; and (4) willing to sign the informed consent and to make time commitment. The exclusion criteria were as follows: (1) receiving physical therapy; (2) suffering from cardiovascular and cerebrovascular diseases; (3) history of head or brain trauma [19,20]; and (4) having cognitive or potential neurological deficits detected by Mini-Mental State Examination [21][22][23] (MMSE).…”