Research Reports - Mild traumatic brain injury in older adults: early cognitive outcome

J Int Neuropsychol Soc. 2014 Jul;20(6):663-71

Kinsella GJ(1), Olver J(2), Ong B(1), Gruen R(3), Hammersley E(1)

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.

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