ABSTRACT

Introduction: In the context of limited research assessing outcomes following mild traumatic brain injury (mTBI) in older adults, this study evaluated cognitive outcomes through prospective memory, and expected that performance of an older mTBI group (≥65 years) would be lower compared to orthopedic and community controls. The study also explored whether cognitive resources (retrospective memory, executive function) moderated any association between presenting Glasgow Coma Scale (GCS) and prospective memory.

Method: At three-months post-injury, a mTBI group (n = 39), an orthopedic control group (n = 63), and a community control group (n = 46) completed a neuropsychological assessment, including (i) prospective memory, using a standardized paper-and-pencil task (Cambridge Prospective Memory Test), an augmented reality task and a naturalistic task, and (ii) standardized measures of retrospective memory (Hopkins Verbal Learning Test) and executive function (Trail Making Test). Group performances were compared, and bootstrapped moderation analyses evaluated the role of cognitive resources in the relationship between GCS and prospective memory outcome.

Results: The mTBI group, as compared to community controls, performed significantly lower on the augmented reality task (d = −0.64 to d = −0.79), and there was a small-moderate but non-significant effect (d = −0.45) on the naturalistic task. There were no differences between the mTBI group and orthopedic controls. Retrospective memory was a unique predictor of the augmented reality task (B = 1.83) and moderated the relationship between presenting GCS and the naturalistic task (B = −5.60). Executive function moderated the association between presenting GCS and augmented reality (B = −1.13) and naturalistic task (B = −1.57).

Conclusions: At three-months post-mTBI, older adults are at risk of poor cognitive performance; and the relationship between GCS and prospective memory can be moderated by cognitive resources. Further follow-up is indicated to determine whether impairments resolve or persist over time.

摘要

简介：在评估老年人轻度创伤性脑损伤 (mTBI) 后结果的研究有限的情况下，本研究通过前瞻性记忆评估认知结果，并预计老年 mTBI 组（≥65 岁）的表现将低于骨科和社区控制。该研究还探讨了认知资源（回顾性记忆、执行功能）是否调节了格拉斯哥昏迷量表 (GCS) 与前瞻性记忆之间的任何关联。

方法：在受伤后三个月，mTBI 组 ( n = 39)、骨科对照组 ( n = 63) 和社区对照组 ( n = 46) 完成了神经心理学评估，包括 (i) 前瞻性记忆，使用标准化的纸笔任务（剑桥前瞻性记忆测试）、增强现实任务和自然主义任务，以及（ii）回顾性记忆（霍普金斯语言学习测试）和执行功能（跟踪测试）的标准化测量。比较了小组表现，并通过自举调节分析评估了认知资源在 GCS 和前瞻性记忆结果之间的关系中的作用。

结果：与社区对照组相比，mTBI 组在增强现实任务上的表现明显较低（d = -0.64 到d = -0.79），并且有一个中等但不显着的影响（d = -0.45）关于自然主义的任务。mTBI 组和骨科对照组之间没有差异。回顾性记忆是增强现实任务的独特预测因子 ( B = 1.83)，并调节了呈现 GCS 与自然任务之间的关系 ( B = -5.60)。执行功能调节了呈现 GCS 和增强现实 ( B = -1.13) 与自然任务 ( B = -1.57)之间的关联。

结论：在 mTBI 后三个月，老年人有认知能力差的风险；GCS与前瞻记忆之间的关系可以通过认知资源来调节。需要进一步随访以确定损伤是否会随着时间的推移而消退或持续。