Prevalence of Disability Associated With Head Injury With Loss of Consciousness in Adults in the United States

Schneider, Andrea L.C.; Wang, Dan; Gottesman, Rebecca F.; Selvin, Elizabeth

doi:10.1212/wnl.0000000000012148

Cited by 26 publications

(17 citation statements)

References 34 publications

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“…More than 2.5 million new cases of traumatic brain injury (TBI) are diagnosed annually in the U.S. and an estimated 11 million individuals are living with long-term TBI-associated disability [ 1 , 2 ]. Epidemiological studies have demonstrated an association between TBI exposure(s) and an increased risk of age-related neurocognitive decline or dementia [ 3 - 7 ], including a 2018 retrospective cohort study involving over 350,000 military veterans which found more than a two-fold increased risk of developing dementia amongst individuals with mild TBI exposure and more than a 3.5-fold increased risk of developing dementia amongst individuals with moderate-to-severe TBI exposure [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Cerebral Microvascular Pathology Is a Common Endophenotype Between Traumatic Brain Injury, Cardiovascular Disease, and Dementia: A Hypothesis and Review

Swanson¹,

Acharya²,

Cifu³

2022

Cureus

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Traumatic brain injury (TBI) exposure has been associated with an increased risk of age-related cognitive decline or dementia in multiple epidemiological studies. Current therapeutic interventions in the field of Brain Injury Medicine focus largely on episodic symptom management during the chronic phase of TBI recovery, rather than targeting specific underlying pathological processes. This approach may be especially problematic for secondary age-related cognitive decline or dementia following TBI exposure. Although there are likely multiple pathophysiological mechanisms involved, a growing body of literature demonstrates that cerebral microvascular pathology is a common endophenotype across the spectrum of TBI severity. Similarly, a combination of pre-clinical and clinical research over the past two decades has implicated cerebral microvascular pathology in the initiation and progression of multiple neurodegenerative diseases, including Alzheimer’s disease and other dementias. We hypothesize that cerebral microvascular pathology is a common endophenotype between TBI, cardiovascular disease (CVD), and dementia, which can be targeted through modifiable cardiovascular risk factor reductions during the chronic phase of TBI recovery. We posit that our hypothesis is supported by the currently available scientific literature, as detailed in our review.

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Section: Introductionmentioning

confidence: 99%

Cerebral Microvascular Pathology Is a Common Endophenotype Between Traumatic Brain Injury, Cardiovascular Disease, and Dementia: A Hypothesis and Review

Swanson¹,

Acharya²,

Cifu³

2022

Cureus

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“…The COVID-19 pandemic has magnified these longstanding inequities [ 11 ]; persons with disabilities are at higher risk of serious illness secondary to underlying neurologic conditions [ 12 , 13 ] and have more difficulty engaging in COVID-19 preventative measures [ 14 ]. Persons with traumatic brain injury (TBI) represent an estimated 11.4 million persons with disability [ 15 ] who may be particularly affected by the pandemic, though currently only one cross-sectional study exists on how the COVID-19 pandemic has affected TBI survivors [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

Changes in alcohol use and mood during the COVID-19 pandemic among individuals with traumatic brain injury: A difference-in-difference study

et al. 2022

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Objective To evaluate the impact of COVID-19 pandemic exposure on changes in alcohol use and mood from years 1 to 2 after traumatic brain injury (TBI). Methods We used a difference-in-difference (DiD) study design to analyze data from 1,059 individuals with moderate-to-severe TBI enrolled in the TBI Model Systems (TBIMS) National Database. We defined COVID-19 pandemic exposure as participants who received their year 1 post-injury interviews prior to January 1, 2020, and their year 2 interview between April 1, 2020 and January 15, 2021. Pandemic-unexposed participants had both year 1 and 2 follow-up interviews before January 1, 2020. We measured current alcohol use as any past month alcohol use, average number of drinks per drinking occasion, and past month binge drinking. We measured depression symptoms using Patient Health Questionnaire-9, and anxiety symptoms using the Generalized Anxiety Disorder-7. Results We found persons with TBI exposed to the pandemic had greater increases in the average number of drinks per occasion from year 1 to 2 post-injury compared to pandemic-unexposed individuals (β = 0.36, 95% CI: 0.16, 0.57, p = 0.001), with males, adults <65 years old, and Black and Hispanic subgroups showing the greatest increases in consumption. Though average consumption was elevated, changes in rates of any alcohol use or binge drinking by pandemic exposure were not observed. Overall, there were no significant changes in depressive and anxiety symptoms over time between pandemic exposed and unexposed groups; however, pandemic-exposed Hispanics with TBI reported significant increases in anxiety symptoms from year-1 to year-2 post-injury compared to pandemic-unexposed Hispanics (β = 2.35, 95% CI: 0.25, 4.47, p = 0.028). Conclusion Among persons living with TBI, those exposed to the pandemic had significant increases in average alcohol consumption. Pandemic-exposed Hispanics with TBI had large elevations in anxiety symptoms, perhaps reflecting health inequities exacerbated by the pandemic, and suggesting a need for targeted monitoring of psychosocial distress.

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“…Persons with acquired brain injury (pwABI), due to either stroke or trauma, can experience long term changes in participation across multiple facets of life (1)(2)(3)(4)(5)(6). Acquired brain injury (ABI) has been found to result in a higher prevalence of disability when compared to the general population (7), and to result in long-term impacts on daily function (8). Helping pwABI engage in valued tasks and roles is a goal shared by pwABI, their families, clinicians, and researchers (9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%

Conceptualization of Participation: A Qualitative Synthesis of Brain Injury Stakeholder Perspectives

Rajala¹,

Waterhouse²,

Evans³

et al. 2022

Front. Rehabilit. Sci.

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BackgroundThe return to participation in meaningful life roles for persons with acquired brain injury (pwABI) is a goal shared by pwABI, their families, clinicians, and researchers. Synthesizing how pwABI define participation will help to identify the aspects of participation important to pwABI and can inform a person-centered approach to participation outcome assessment. To-date, the qualitative synthesis approach has been used to explore facilitators and barriers of participation post-stroke, and views about participation among individuals with stroke in the UK.ObjectivesThis paper's objectives are to (1) conduct a scoping review of qualitative literature that defines and characterizes participation from the perspective of pwABI of any type, (2) synthesize how pwABI define and categorize participation, and (3) link the themes identified in the qualitative synthesis to the International Classification of Functioning, Disability, and Health (ICF) using standardized linking rules to enhance the comparability of our findings to other types of health information, including standardized outcome measures.MethodsWe completed a scoping review of qualitative literature. Our search included PubMed, APA PsychInfo, CINAHL, and Embase databases and included articles that (1) had qualitative methodology, (2) had a sample ≥50% pwABI, (3) had aims or research questions related to the meaning, definition, perception, or broader experience of participation, and (4) were in English. Qualitative findings were synthesized using Thomas and Harden's methodology and resultant themes were linked to ICF codes.ResultsThe search identified 2,670 articles with 2,580 articles excluded during initial screening. The remaining 90 article abstracts were screened, and 6 articles met the full inclusion criteria for the qualitative synthesis. Four analytical themes emerged: (1) Essential Elements of Participation (2) How pwABI Approach Participation, (3) Where pwABI Participate, and (4) Outcomes of Participation. Each overarching theme included multiple descriptive themes.ConclusionIn this paper, we identified themes that illustrate key components of participation to pwABI. Our results provide insight into the complex perspectives about participation among pwABI and illustrate aspects of participation that should hold elevated importance for clinicians and researchers supporting participation of pwABI.

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Prevalence of Disability Associated With Head Injury With Loss of Consciousness in Adults in the United States

Cited by 26 publications

References 34 publications

Cerebral Microvascular Pathology Is a Common Endophenotype Between Traumatic Brain Injury, Cardiovascular Disease, and Dementia: A Hypothesis and Review

Cerebral Microvascular Pathology Is a Common Endophenotype Between Traumatic Brain Injury, Cardiovascular Disease, and Dementia: A Hypothesis and Review

Changes in alcohol use and mood during the COVID-19 pandemic among individuals with traumatic brain injury: A difference-in-difference study

Conceptualization of Participation: A Qualitative Synthesis of Brain Injury Stakeholder Perspectives

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