| Titre : | Identification of Factors in Moderate-Severe TBI Related to a Functional Decline in Cognition Decades After Injury (2023) |
| Auteurs : | Christian LoBue ; Jeff Schaffert ; Kristen Dams-O'Connor ; Zinat Taiwo ; Angelle Sander ; Umesh M. Venkatesan ; Therese M. O'Neil-Pirozzi ; Flora M. Hammond ; Kristin Wilmoth ; Kan Ding ; Kathleen Bell ; C. Munro Cullum |
| Type de document : | Article |
| Dans : | Archives of Physical Medicine and Rehabilitation (Vol. 104, n° 11, 2023) |
| Article en page(s) : | p. 1865-1871 |
| Note générale : | https://doi.org/10.1016/j.apmr.2023.04.017 |
| Langues: | Anglais |
| Descripteurs : |
HE Vinci Amnésie ; Cognition ; Démence ; Lésions traumatiques de l'encéphale ; Réadaptation |
| Résumé : | 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. |
| Disponible en ligne : | Oui |
| En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/article/pii/S000399932300285X |
Bibliothèques HE Vinci
