Health and cognition among adults with and without Traumatic Brain Injury: A matched case-control study.
Raj G Kumar, Jessica M Ketchum, Flora M Hammond and 4 others
PMID 35143349WHAT IT FOUND
One year after moderate-to-severe TBI, adults were more likely to report anxiety/depression/other emotional disorder, chronic sleep problems, and stroke than matched uninjured adults.
Poor self-rated health also tracked with much lower thinking scores in TBI than controls.
Key findings
01After Bonferroni correction, anxiety/depression/other emotional disorder (OR=3.12), chronic sleeping problems (OR=2.76), and stroke (OR=6.42) were significantly positively associated with TBI, and no condition was significantly more common in controls.
02Among TBI cases, poor self-rated health was linked to a 1.55 lower mean cognitive composite score than average self-rated health; among controls, poor health was linked to a 0.39 lower score.
03After adjustment for multiple comparisons, no individual health condition significantly modified the association between TBI and cognitive scores.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The study cannot tell whether health conditions existed before injury, occurred around the same time, or developed after injury. It compared people who received inpatient rehabilitation for moderate-to-severe TBI with general survey controls, so it may not apply to people with mild TBI or those who did not receive specialized brain injury rehabilitation. 116 TBI cases were removed for missing health information before matching. The two source studies had different age ranges, so matching was loosened at the youngest and oldest ends. Controls were not coded for inability to complete cognitive tests, so some controls with severe cognitive impairment may have been missed. The list of health conditions was not comprehensive, and unmeasured differences between groups could still explain the findings.
Declared interests
The authors declared no conflicts of interest. The TBI data came from a cohort funded by the National Institute on Disability, Independent Living, and Rehabilitation Research.
The easy way to misread this
Do not read the higher prevalence of anxiety/depression, sleep problems, and stroke as proof that TBI caused them or that treating them will improve cognition. The study measured health conditions at one year, could not tell whether they were pre-existing or new, and found no significant effect of individual conditions on the TBI-cognition relationship.