Cognitive impairments are common sequelae of traumatic brain injury (TBI) and are often associated with the natural process of aging. Few studies have examined the effect of both age and TBI on ...cognitive functioning. The purpose of this study was to compare cognitive functioning between older adults who sustained a TBI to an age-matched group of individuals without a brain injury and to determine whether the presence or absence of a genetic marker apolipoprotein epsilon (APOEepsilon4 allele) accounts for additional cognitive decline in both groups examined.
Cognitive performance was measured by 11 neuropsychological tests, in 54 adults with TBI aged 55 and older and 40 age-matched control participants. All participants were reexamined 2 to 5 years later.
Community volunteer-based sample examined at a large, urban medical center.
California Verbal Learning Test; Wechsler Memory Scale-III (Logical Memory I & II; Visual Reproduction I & II); Grooved Pegboard; Woodcock-Johnson Test of Cognitive Ability (Visual Matching and Cross-out); Wisconsin Card Sorting Test; Trail Making Test A & B; Conners' Continuous Performance Task; Wechsler Adult Intelligence Scale-III (Vocabulary); Controlled Oral Word Association Test; and Boston Naming Test.
Participants with TBI had lower scores on tests of attention and verbal memory than did participants with no disability. Neither group exhibited a significant decline in cognitive function over time. The presence of the APOEepsilon4 allele did not account for additional decline in cognitive function in either group.
The findings suggest that older adults with TBI may not be at increased risk for cognitive decline over short time periods (2 to 5 years) even if they are carriers of the APOEepsilon4 allele.
This pilot study examined the utility of self-discrepancy theory (SDT) in explaining post-traumatic brain injury (TBI) depression and anxiety. The SDT model was expanded to include the discrepancy ...between the postinjury self and the preinjury self. Study participants were 21 individuals with mild to severe TBI residing in the community, who completed the Selves Interview, the Selves Adjective Checklist, the Beck Depression Inventory-II and the Beck Anxiety Inventory. Strong correlations were found between affective distress and self-discrepancies, as measured by the checklist. Scores on the interview were not related to affective distress. The findings suggest that further research is merited to examine the utility of the SDT in addressing issues of post-TBI depression and anxiety.
Measurement and assessment, occurring within both research and clinical service contexts, typically involve an imbalance of power between professionals and persons with disabilities. Power is ...evidenced in who controls decisions about measurement and whose perspective--the subjective values of the measured person or the objective or normative values of the measurer--is given primacy. The consequences of this imbalance are discussed with respect to both sides of the power relationship. For clinicians, evaluators, and researchers, who typically hold most, if not all of the power in measurement, the process may produce data that meet the highest professional standards. However, the utility of such data is limited in addressing many purposes. For research participants and service recipients, who typically have little if any control of measurement, the measurement process may be disempowering, because measures focus on areas of life that may be of little relevance to what they see as important. In effect, both sides lose, to the degree that resulting data are less revealing than would be the case in a more balanced power relationship. Methods are discussed for reducing power imbalances to improve the utility and efficacy of measurement.
At least 1.4 million people die, or receive hospital or emergency care every year in the United States as a result of traumatic brain injury (TBI). Many more are treated in other settings or receive ...no treatment at all. Thus TBI is often unidentified, with subsequent cognitive, behavioral, emotional and physical sequelae that are not linked to the injury. Yet, over 5.3 million Americans live with TBI-related disabilities that interfere with their overall performance and social roles within the community. The pathophysiology and consequences of TBI are discussed, as are functional changes and psychiatric manifestations after TBI. Finally, implications and recommendations for clinical practice are reviewed, including the importance of screening for TBI.
Objective:
To compare the extent of engagement in social-recreational activity in individuals with traumatic brain injury (TBI) and with no disability (ND).
Study Design:
Between- and within-group ...comparisons.
Participants:
Samples (TBI,
N
= 279; ND,
N
= 224) recruited from community sources.
Outcome Measures:
A social-recreational measure based on items drawn from 3 measures of community integration.
Results:
The ND group was more active than the TBI group. For the latter, greater social-recreational activity was associated with being single, higher income, less depression, more vocational hours, and greater time since injury.
Conclusions:
Addressing depression, fatigue, and vocational engagement may promote entrée to a fuller social-recreational life for individuals with TBI.
The impact of age on traumatic brain injury Flanagan, Steven R; Hibbard, Mary R; Gordon, Wayne A
Physical medicine and rehabilitation clinics of North America,
02/2005, Letnik:
16, Številka:
1
Journal Article
Recenzirano
Older individuals with TBI differ from younger adults with TBI in several ways, including their incidence rates, etiology of injury, nature of complications, lengths of hospitalization, functional ...outcomes, and mortality. Despite the greater likelihood of poorer functional outcomes, older adults with TBI often achieve good functional outcomes and can live in community settings after receiving appropriate rehabilitation services, although at higher costs and longer hospitalizations than younger individuals. The future of rehabilitation care for elderly patients after TBI is uncertain due to financial limitations associated with the implementation of the PPS payment system by CMS. Little is known regarding the long-term impact of TBI on individuals as they age, but this is an important issue as the population ages.
In this study, self-reported symptoms (cognitive, physical, behavioural/affective) from the TIRR Symptom Checklist are compared across six panels: 135 individuals with mild TBI, 275 with ...moderate/severe TBI, 287 with no disability, 104 with spinal cord injury, 197 who are HIV positive and 107 who had undergone liver transplantation. Participants with TBI and SCI were at least 1 year postinjury. Individuals with TBI reported significantly more symptoms than other panels. Symptom reports in the TBI panels were independent of demographic variables (gender, education, income, ethnicity, age), as well as time since injury and depression. Five of the 67 symptoms were found to be sensitive/specific to TBI in general; 25 symptoms were sensitive/specific to mild TBI (23 were cognitive, one physical and one behavioural/affective). Implications of these results in terms of current debates about the 'reality' of symptom reports in individuals with mild TBI are discussed, as well as implications for using symptom checklists for TBI screening.
To compare patterns of cognitive functioning in older adults with traumatic brain injury (TBI), Alzheimer's disease (AD), and no neurological disorder (ND).
Group comparison.
Outpatient setting of a ...large urban tertiary care medical center.
Older adults: 56 with TBI, 64 with AD, and 50 with neurological disorder.
None.
Older adults with AD and TBI had lower scores in most areas of cognitive functioning examined than the individuals with neurological disorder. Individuals with AD had lower scores in memory, processing speed, and verbal fluency than did individuals with TBI. Specifically, individuals with AD did not retain learned information over time.
Cognitive impairments were present in older adults with AD and TBI. However, individuals with TBI were better able to learn and retain new information than were individuals with AD.
PDF
