1
|
Schaffert J, LoBue C, Chiang HS, Peters ME, Hart Jr J, Cullum CM. Traumatic Brain Injury Characteristics Are Not Related to Neurocognitive Decline in Older Adults: A Nationwide Longitudinal Cohort Study. Arch Clin Neuropsychol 2024; 39:325-334. [PMID: 38332549 PMCID: PMC11042919 DOI: 10.1093/arclin/acae003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 12/13/2023] [Accepted: 01/17/2023] [Indexed: 02/10/2024] Open
Abstract
OBJECTIVE Evaluate whether traumatic brain injury (TBI) characteristics, age of injury, or recency of injury predicts the course of neurocognitive decline and/or increases conversion rates to mild cognitive impairment (MCI) or dementia. METHODS Data were obtained from the National Alzheimer's Coordinating Center for participants 50-85 years old with 3-5 visits from 2015 to 2022, with or without TBI history (TBI+ = 508; TBI- = 2,382). Groups were stratified by self-reported TBI history (i.e., single TBI without loss of consciousness [LOC], single TBI with LOC, multiple TBI without LOC, and multiple TBI with LOC), age of most recent TBI, and recency of TBI. Mixed linear models compared neuropsychological composite trajectories (executive functioning/attention/speed, language, memory, and global), co-varying for age, gender, education, apolipoprotein E4 status, race/ethnicity, and baseline diagnosis (normal aging n = 1,720, MCI n = 749, or dementia n = 417). Logistic binary regression examined MCI/dementia conversion rates. RESULTS There was a slightly higher frequency of MCI/dementia in those with multiple TBIs (50% to 60% with and without LOC, compared to 39% with no TBI) at baseline, but longitudinal trajectories were similar. TBI history, age of injury, or recency of injury did not impact neurocognitive trajectories or conversion rates to MCI/dementia (all p's > .01). CONCLUSIONS TBI history, regardless of injury characteristics, age of injury, or recency of injury, did not worsen neurocognitive decline or MCI/dementia conversion. Additional longitudinal research in more diverse cohorts with a wider range of TBI severity is needed to evaluate the specific factors and possible mechanisms in which TBI may increase dementia risk.
Collapse
Affiliation(s)
- Jeff Schaffert
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX 75390, USA
| | - Christian LoBue
- Departments of Psychiatry and Neurological Surgery, UT Southwestern Medical Center, Dallas, TX 75390, USA
| | - Hsueh-Sheng Chiang
- Department of Neurology, UT Southwestern Dallas Medical Center, Dallas, TX 75390, USA
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX 75080, USA
| | - Matthew E Peters
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - John Hart Jr
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX 75080, USA
- Departments of Neurology and Psychiatry, UT Southwestern Medical Center, Dallas, TX 75390, USA
| | - C Munro Cullum
- Departments of Psychiatry, Neurology, and Neurological Surgery, UT Southwestern Medical Center, Dallas, TX 75390, USA
| |
Collapse
|
3
|
Greenberg J, Kanaya MR, Bannon SM, McKinnon E, Iverson GL, Silverberg ND, Parker RA, Giacino JT, Yeh GY, Vranceanu AM. The Impact of a Recent Concussion on College-Aged Individuals with Co-Occurring Anxiety: A Qualitative Investigation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20031988. [PMID: 36767359 PMCID: PMC9915955 DOI: 10.3390/ijerph20031988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 01/18/2023] [Accepted: 01/19/2023] [Indexed: 05/25/2023]
Abstract
College-aged individuals with anxiety are vulnerable to developing persistent concussion symptoms, yet evidence-based treatments for this population are limited. Understanding these individuals' perspectives is critical for developing effective interventions. We conducted qualitative interviews with 17 college-aged individuals (18-24 years old) with a recent (≤10 weeks) concussion and at least mild anxiety (≥5 on the GAD-7 questionnaire) to understand the life impact of their concussion. We identified 5 themes: (1) disruption to daily activities (e.g., reduced participation in hobbies and physical activity); (2) disruption to relationships (e.g., reduced social engagement, feeling dismissed by others, stigma, and interpersonal friction); (3) disruptions in school/work (e.g., challenges participating due to light sensitivity, cognitive or sleep disturbance, and related emotional distress); (4) changes in view of the self (e.g., feeling "unlike oneself", duller, or more irritable), and (5) finding "silver linings" after the injury (e.g., increased motivation). Concussions impact the lives of college-aged individuals with co-occurring anxiety in a broad range of domains, many of which remain largely neglected in standard concussion clinical assessment and treatment. Assessing and addressing these issues has the potential to limit the negative impact of concussion, promote recovery, and potentially help prevent persistent concussion symptoms in this at-risk population.
Collapse
Affiliation(s)
- Jonathan Greenberg
- Center for Health Outcomes and Interdisciplinary Research (CHOIR), Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA
- Harvard Medical School, Boston, MA 02115, USA
| | - Millan R. Kanaya
- Center for Health Outcomes and Interdisciplinary Research (CHOIR), Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Sarah M. Bannon
- Center for Health Outcomes and Interdisciplinary Research (CHOIR), Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA
- Harvard Medical School, Boston, MA 02115, USA
| | - Ellen McKinnon
- Dr. Robert Cantu Concussion Center, Emerson Hospital, Concord, MA 01742, USA
| | - Grant L. Iverson
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and The Schoen Adams Research Institute at Spaulding Rehabilitation, Charlestown, MA 02129, USA
- MassGeneral Hospital for Children Sports Concussion Program, Boston, MA 02114, USA
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA 02115, USA
| | - Noah D. Silverberg
- Department of Psychology, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
- Rehabilitation Research Program, Vancouver Coastal Health Research Institute, Vancouver, BC V5Z 1M9, Canada
| | - Robert A. Parker
- Harvard Medical School, Boston, MA 02115, USA
- Biostatistics Center, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Joseph T. Giacino
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA 02115, USA
- Spaulding Rehabilitation Hospital, Charlestown, MA 02129, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Gloria Y. Yeh
- Harvard Medical School, Boston, MA 02115, USA
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
| | - Ana-Maria Vranceanu
- Center for Health Outcomes and Interdisciplinary Research (CHOIR), Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA
- Harvard Medical School, Boston, MA 02115, USA
| |
Collapse
|