Identification of Factors in Moderate-Severe TBI Related to a Functional Decline in Cognition Decades After Injury
dc.contributor.author | LoBue, Christian | |
dc.contributor.author | Schaffert, Jeff | |
dc.contributor.author | Dams-O’Connor, Kristen | |
dc.contributor.author | Taiwo, Zinat | |
dc.contributor.author | Sander, Angelle | |
dc.contributor.author | Venkatesan, Umesh M. | |
dc.contributor.author | O’Neil-Pirozzi, Therese M. | |
dc.contributor.author | Hammond, Flora M. | |
dc.contributor.author | Wilmoth, Kristin | |
dc.contributor.author | Ding, Kan | |
dc.contributor.author | Bell, Kathleen | |
dc.contributor.author | Cullum, C. Munro | |
dc.contributor.department | Physical Medicine and Rehabilitation, School of Medicine | |
dc.date.accessioned | 2024-12-13T16:03:56Z | |
dc.date.available | 2024-12-13T16:03:56Z | |
dc.date.issued | 2023 | |
dc.description.abstract | Objective: To investigate whether a functional decline in cognitive activities decades after moderate-to-severe traumatic brain injury (m-sTBI) might relate to injury features and/or lifetime health factors, some of which may emerge as consequences of the injury. Design: Secondary analysis of the TBI Model Systems National Database, a prospective, multi-center, longitudinal study of patients with m-sTBI. Setting: TBI Model Systems Centers. Participants: Included were 732 participants rated on the cognitive subscale of the Functional Independence Measure (FIM Cognitive), a metric for everyday cognitive skills, across 3 time points out to 20 years (visits at 2-, 10-, and 20-year follow-ups; N=732). Interventions: Not applicable. Main outcome measure(s): FIM Cognitive Scale. Injury characteristics such as timing and features pertaining to severity and health-related factors (eg, alcohol use, socioeconomic status) were examined to discriminate stable from declining participants on the FIM Cognitive Scale using logistic regression. Results: At 20 years post-injury, there was a low base rate of FIM Cognitive decline (11%, n=78), with most being stable or having meaningful improvement (89%, n=654). Older age at injury, longer duration of post-traumatic amnesia, and presence of repetitive seizures were significant predictors of FIM Cognitive decline in the final model (area under the curve=0.75), while multiple health-related factors that can represent independent co-morbidities or possible consequences of injury were not. Conclusion(s): The strongest contributors to reported functional decline in cognitive activities later-in-life were related to acute characteristics of m-sTBI and experiencing post-traumatic seizures. Future studies are needed integrating functional with performance-based cognitive assessments to affirm conclusions and identify the timeline and trajectory of cognitive decline. | |
dc.eprint.version | Author's manuscript | |
dc.identifier.citation | LoBue C, Schaffert J, Dams-O'Connor K, et al. Identification of Factors in Moderate-Severe TBI Related to a Functional Decline in Cognition Decades After Injury. Arch Phys Med Rehabil. 2023;104(11):1865-1871. doi:10.1016/j.apmr.2023.04.017 | |
dc.identifier.uri | https://hdl.handle.net/1805/45036 | |
dc.language.iso | en_US | |
dc.publisher | Elsevier | |
dc.relation.isversionof | 10.1016/j.apmr.2023.04.017 | |
dc.relation.journal | Archives of Physical Medicine and Rehabilitation | |
dc.rights | Publisher Policy | |
dc.source | PMC | |
dc.subject | Amnesia | |
dc.subject | Cognition | |
dc.subject | Dementia | |
dc.subject | Rehabilitation | |
dc.subject | Traumatic brain injury | |
dc.title | Identification of Factors in Moderate-Severe TBI Related to a Functional Decline in Cognition Decades After Injury | |
dc.type | Article |