Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-26T05:10:52.502Z Has data issue: false hasContentIssue false

Mild Traumatic Brain Injury in Older Adults: Early Cognitive Outcome

Published online by Cambridge University Press:  16 May 2014

Glynda J. Kinsella*
Affiliation:
Psychological Science, La Trobe University, Melbourne, Australia Psychology Department, Caulfield Hospital, Melbourne, Australia
John Olver
Affiliation:
Rehabilitation & Psychiatry, Epworth Healthcare, Melbourne, Australia Faculty of Medicine, Monash University, Melbourne, Australia
Ben Ong
Affiliation:
Psychological Science, La Trobe University, Melbourne, Australia
Russell Gruen
Affiliation:
Faculty of Medicine, Monash University, Melbourne, Australia National Trauma Research Institute, Melbourne, Australia Department of Surgery, The Alfred Hospital, Melbourne, Australia
Eleanor Hammersley
Affiliation:
Psychological Science, La Trobe University, Melbourne, Australia
*
Correspondence and reprint requests to: Glynda Kinsella, Psychological Science, La Trobe University, Melbourne, VIC 3086. Australia. E-mail: [email protected]

Abstract

Severe traumatic brain injury (TBI) in older age is associated with high rates of mortality. However, little is known about outcome following mild TBI (mTBI) in older age. We report on a prospective cohort study investigating 3 month outcome in older age patients admitted to hospital-based trauma services. First, 50 mTBI older age patients and 58 orthopedic controls were compared to 123 community control participants to evaluate predisposition and general trauma effects on cognition. Specific brain injury effects were subsequently evaluated by comparing the orthopedic control and mTBI groups. Both trauma groups had significantly lower performances than the community group on prospective memory (d=0.82 to 1.18), attention set-shifting (d=−0.61 to −0.69), and physical quality of life measures (d=0.67 to 0.84). However, there was only a small to moderate but non-significant difference in the orthopedic control and mTBI group performances on the most demanding task of prospective memory (d=0.37). These findings indicate that, at 3 months following mTBI, older adults are at risk of poor cognitive performance but this is substantially accounted for by predisposition to injury or general multi-system trauma. (JINS, 2014, 20, 1–9)

Type
Research Articles
Copyright
Copyright © The International Neuropsychological Society 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aharon-Peretz, J., Kliot, D., Amyel-Zvi, E., Tomer, R., Rakier, A., & Feinsod, M. (1997). Neurobehavioural consequences of closed head injury in the elderly. Brain Injury, 11, 871875.CrossRefGoogle ScholarPubMed
Albert, M., Moss, M., Tanzi, R., & Jones, K. (2001). Preclinical prediction of AD using neuropsychological tests. Journal of the International Neuropsychological Society, 7, 631639.CrossRefGoogle ScholarPubMed
Australian Bureau of Statistics (2009). Australian and New Zealand Classification of Occupations (ANZSCO), (revision 1, cat. no. 1220.0). Canberra: ABS.Google Scholar
Belanger, H.G., Curtiss, G., Demery, J.A., Lebowitz, B.K., & Vanderploeg, R.D. (2005). Factors moderating neuropsychological outcomes following mild traumatic brain injury: A meta-analysis. Journal of the International Neuropsychological Society, 11, 215227.CrossRefGoogle ScholarPubMed
Bradley, C. (2013). Hospitalisations due to falls by older people, Australia 2009–10. (Injury research and statistics series no. 70. Cat. no. INJCAT 146. Canberra: AIHW.Google Scholar
Brandt, J., & Benedict, R.H.B. (2001). Hopkins Verbal Learning Test-Revised. Professional manual. Lutz, FL: Psychological Assessment Resources, Inc.Google Scholar
Carroll, L.J., Cassidy, J.D., Holm, L., Kraus, J., & Coronado, V.G. (2004). Methodological issues and research recommendations for mild traumatic brain injury: The WHO collaborating centre task force on mild traumatic brain injury. Journal of Rehabilitation Medicine, Supplement, 43, 113125.CrossRefGoogle Scholar
Cassidy, J.D., Carroll, L.J., Peloso, P.M., Borg, J., von Holst, H., Holm, L., … WHO Collaborating Centre Task force on Mild Traumatic Brain Injury (2004). Incidence, risk factors and prevention of mild traumatic brain injury: Results of the WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury. Journal of Rehabilitation Medicine, 43, 2860.CrossRefGoogle Scholar
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Erlbaum.Google Scholar
Copes, W.S., Champion, H.R., Sacco, W.J., Lawnick, M.M., Keast, S.L., & Bain, L.W. (1988). The Injury Severity Score revisited. Journal of Trauma, 28, 6977.CrossRefGoogle ScholarPubMed
Coronado, V.G., Thomas, K.E., Sattin, R.W., & Johnson, R.L. (2005). The CDC Traumatic Brain Injury Surveillance System: Characteristics of Persons Aged 65 years and Older Hospitalized With a TBI. Journal of Head Trauma Rehabilitation, 20, 215228.CrossRefGoogle ScholarPubMed
Delis, D.C., Kaplan, E., & Kramer, J.H. (2001). Delis-Kaplan Executive Function System (D-KEFS). San Antonio, TX: The Psychological Corporation.Google Scholar
Dikmen, S., Machamer, J., Fann, J.R., & Temkin, N.R. (2010). Rates of symptom reporting following traumatic brain injury. Journal of the International Neuropsychological Society, 16, 401411.CrossRefGoogle ScholarPubMed
Dikmen, S., Machamer, J., Winn, H.R., & Temkin, N.R. (1995). Neuropsychological outcome at 1-year post head injury. Neuropsychology, 9, 8090.CrossRefGoogle Scholar
Einstein, G.O., & McDaniel, M.A. (2005). Prospective memory: Multiple retrieval processes. Current Directions in Psychological Science, 14(6), 286290. doi:10.1111/j.0963-7214.2005.00382.xCrossRefGoogle Scholar
Faul, M., Xu, L., Wald, M.M., & Coronado, V.G. (2010). Traumatic brain injury in the United States: Emergency department visits, hospitalizations and deaths 2002–2006. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control.CrossRefGoogle Scholar
Fleming, J., Riley, L., Gill, H., Gullo, M.J., Strong, J., & Shum, D. (2008). Predictors of prospective memory in adults with traumatic brain injury. Journal of the International Neuropsychological Society, 14, 823831.CrossRefGoogle ScholarPubMed
Gallo, J.J., & Pavesa, G.J. (2006). Activities of daily living and instrumental activities of daily living assessment. In J.J. Gallo, H.R. Bogner, T. Fulmer, & G.J. Pavesa (Eds.), Handbook of geriatric assessment (4th ed., pp. 193240). Sudbury, MA. Jones and Bartlett Publishers.Google Scholar
Gennarelli, T.A., & Wodzin, E. (2008). The Abbreviated Injury Scale 2005. Update 2008. Des Plaines, IL: American Association for Automotive Medicine (AAAM).Google Scholar
Gillespie, L.D., Robertson, M.C., Gillespie, W.J., Sherrington, C., Gates, S., Clemson, L.M., & Lamb, S.E. (2012). Interventions for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews, 9, CD007146. doi:10.1002/14651858.CD007146.pub3Google Scholar
Goldstein, F.C., Levin, H.S., Goldman, W.P., Clark, A.N., & Altonen, T.K. (2001). Cognitive and neurobehavioural functioning after mild versus moderate traumatic brain injury in older adults. Journal of the International Neuropsychological Society, 7, 373383.CrossRefGoogle ScholarPubMed
Grady, C. (2012). The cognitive neuroscience of ageing. Nature Reviews Neuroscience, 13, 491505.CrossRefGoogle ScholarPubMed
Harrison, J., Henley, G., & Helps, Y. (2008). Hospital separations due to traumatic brain injury, Australia 2004–05. Injury research and statistics series no. 45. Cat. no. INJCAT 116; Canberra: AIHW.Google Scholar
Hukkelhoven, C.W., Steyerberg, E.W., Rampen, A.J., Farace, E., Habbema, J.D., Marshall, L.F., Maas, A.I. (2003). Patient age and outcome following severe traumatic brain injury: An analysis of 5600 patients. Journal of Neurosurgery, 99, 666673.CrossRefGoogle ScholarPubMed
Kinsella, G.J., Mullaly, E., Rand, E., Ong, B., Burton, C., Price, S., … Storey, E. (2009). Early cognitive intervention for mild cognitive impairment: A randomized controlled trial. Journal of Neurology, Neurosurgery and Psychiatry, 80, 730736.CrossRefGoogle Scholar
Larrabee, G.J., Binder, L.M., Rohling, M.L., & Ploetz, D.M. (2013). Meta-analytic methods and the importance of non-TBI factors related to outcome in mild traumatic brain injury: Response to Bigler et al. 2013. Clinical Neuropsychologist, 27(2), 215237. doi:10.1080/13854046.2013.769634CrossRefGoogle ScholarPubMed
Levin, H.S., Hanten, G., Roberson, G., Li, X., Ewing-Cobbs, L., Dennis, M., Swank, P. (2008). Prediction of cognitive sequelae based on abnormal computed tomography findings in children following mild traumatic brain injury. Journal of Neurosurgery: Pediatrics, 1, 461470.Google ScholarPubMed
Lezak, M.D., Howieson, D.B., Bigler, E.D., & Tranel, D. (2012). Neuropsychological assessment (5th ed.). New York: Oxford University Press.Google Scholar
Maas, A.I.R., Stocchetti, N., & Bullock, R. (2008). Moderate and severe traumatic brain injury in adults. Lancet Neurology, 7, 728741.CrossRefGoogle ScholarPubMed
McCrae, M.A. (2008). Mild traumatic brain injury and postconcussion syndrome. New York: Oxford University Press.Google Scholar
McDaniel, M.A., & Einstein, G.O. (2000). Strategic and automatic processes in prospective memory retrieval: A multiprocess framework. Applied Cognitive Psychology, 14, S127S144.CrossRefGoogle Scholar
McDaniel, M.A., & Einstein, G.O. (2011). The neuropsychology of prospective memory in normal aging: A componential approach. Neuropsychologia, 49, 21472155.CrossRefGoogle ScholarPubMed
McIntyre, A., Mehta, S., Aubut, J., Dijkers, M., & Teasell, R.W. (2013). Mortality among older adults after a traumatic brain injury: A meta-analysis. Brain Injury, 27, 3140.CrossRefGoogle ScholarPubMed
Mosenthal, A.C., Lavery, R.F., Addis, M., Kaul, S., Ross, S., Marburger, R., Livingston, D.H. (2002). Isolated traumatic brain injury: Age is an independent predictor of mortality and early outcome. The Journal of Trauma, 52, 907911.Google ScholarPubMed
MRC CRASH Trial Collaborators. (2008). Predicting outcome after traumatic brain injury: Practical prognostic models based on large cohort of international patients. British Medical Journal, 336, 425429.CrossRefGoogle Scholar
Pluijm, S.M.F., Smit, J.H., Tromp, E.A.M., Stel, V.S., Deeg, D.J., Bouter, L.M., & Lips, P. (2006). A risk profile for identifying community-dwelling elderly with a high risk of recurrent falling: Results of a 3-year prospective study. Osteoporosis International, 17, 417425.CrossRefGoogle ScholarPubMed
Ponsford, J., Willmott, C., Rothwell, A., Cameron, P., Kelly, A.-M., Nelms, R., … Ng, K. (2000). Factors influencing outcome following mild traumatic brain injury in adults. Journal of the International Neuropsychological Society, 6, 568579.CrossRefGoogle ScholarPubMed
Rapoport, M.J., Herrmann, N., Shammi, P., Kiss, A., Phillips, A., & Feinstein, A. (2006). Outcome after traumatic brain injury sustained in older adulthood: A one year longitudinal study. American Journal of Geriatric Psychiatry, 14, 456465.CrossRefGoogle ScholarPubMed
Rathlev, N.K., Medzon, R., Lowery, D., Pollack, C., Bracken, M., Barest, G., … Mower, W.R. (2006). Intracranial pathology in elders with blunt head trauma. Academic Emergency Medicine, 3, 302307.CrossRefGoogle Scholar
Reitan, R.M., & Wolfson, D. (1995). Category Test and Trail Making Test as measures of frontal lobe functioning. The Clinical Neuropsychologist, 9, 5056.CrossRefGoogle Scholar
Senathi-Raja, D., Ponsford, J., & Schonberger, M. (2010). Impact of age on long-term cognitive function after traumatic brain injury. Neuropsychology, 24, 336344.CrossRefGoogle ScholarPubMed
Scuffham, P., Chaplin, S., & Legood, R. (2003). Incidence and costs of unintentional falls in older people in the United Kingdom. Journal of Epidemiology and Community Health, 5, 740744.CrossRefGoogle Scholar
Shum, D., Levin, H., & Chan, R.C.K. (2011). Prospective memory in patients with closed head injury. Neuropsychologia, 49, 21562165.CrossRefGoogle ScholarPubMed
Stevens, J.A., Corso, P.S., Finkelstein, E.A., & Miller, T.R. (2006). The costs of fatal and non-fatal falls among older adults. Injury Prevention, 12, 290295.CrossRefGoogle ScholarPubMed
Stocchetti, N., Paterno, R., Citerio, G., Beretta, L., & Colombo, A. (2012). Traumatic brain injury in an aging population. Journal of Neurotrauma, 29, 11191125.CrossRefGoogle Scholar
Tay, S.Y., Ang, B.T., Lau, X.Y., Meyyappan, A., & Collinson, S.L. (2010). Chronic impairment of prospective memory after mild traumatic brain injury. Journal of Neurotrauma, 27, 7783.CrossRefGoogle ScholarPubMed
Teasdale, G., & Jennett, B. (1974). Assessment of coma and impaired consciousness: A practical scale. Lancet, 2, 8184.CrossRefGoogle ScholarPubMed
Thompson, H.J., McCormick, W.C., & Kagan, S.H. (2006). Traumatic brain injury in older adults: Epidemiology, outcomes, and future implications. Journal of the American Geriatric Society, 54, 15901595.CrossRefGoogle ScholarPubMed
Tinetti, M.E. (2003). Preventing falls in elderly persons. The New England Journal of Medicine, 348, 4249. doi:10.1056/NEJMcp020719CrossRefGoogle ScholarPubMed
United Nations. (2012). Ageing in the twenty-first century: A celebration and a challenge. New York: United Nations Fund for Population Ageing (UNFPA).Google Scholar
Utomo, W.K., Gabbe, B.J., Simpson, P.M., & Cameron, P.A. (2009). Predictors of in hospital mortality and 6 month functional outcomes in older adults after moderate to severe traumatic brain injury. Injury, 40, 973977.CrossRefGoogle ScholarPubMed
Ware, J.E., Kosinski, M., Turner-Bowker, D.M., & Gandek, B. (2002). How to Score Version 2 of the SF-12v2® Health Survey (With a Supplement Documenting SF-12® Health Survey) Lincoln, RI: QualityMetric Incorporated.Google Scholar
Wechsler, D. (1997). Wechsler Memory Scale, Third Edition. San Antonio, TX: The Psychological Corporation.Google Scholar
Willer, B., Rosenthal, M., Kreutzer, J.S., Gordon, A., & Rempel, R. (1993). Assessment of community integration following rehabilitation for traumatic brain injury. Journal of Head Trauma Rehabilitation, 8, 7587.CrossRefGoogle Scholar
Williams, W.H., Potter, S., & Ryland, H. (2010). Mild traumatic brain injury and Postconcussion Syndrome: A neuropsychological perspective. Journal of Neurology Neurosurgery, and Psychiatry, 81, 11161122.CrossRefGoogle ScholarPubMed
Wilson, B.A., Emslie, H., Foley, J., Shiel, A., Watson, P., Hawkins, K., … Evans, J.J. (2005). The Cambridge Prospective Memory Test (CAMPROMPT). London: Harcourt Assessment.Google Scholar
Woods, S.P., Weinborn, M., Velnoweth, A., Rooney, A., & Bucks, R.S. (2011). Memory for intentions is uniquely associated with instrumental activities of daily living in healthy older adults. Journal of the International Neuropsychological Society, 18, 134138.CrossRefGoogle ScholarPubMed
Yeates, K.O., Taylor, H.G., Rusin, J., Bangert, B., Dietrich, A., Nuss, K., … Jones, B.L. (2009). Longitudinal trajectories of postconcussive symptoms in children with mild traumatic brain injuries and their relationship to acute clinical status. Pediatrics, 123, 735743.CrossRefGoogle ScholarPubMed