Predictors of cognitive gains during inpatient rehabilitation for older adults with traumatic brain injury.
Lindsey Byom, Amy T Zhao, Qing Yang and 4 others
PMID 35233983WHAT IT FOUND
Older adults with TBI made clinically meaningful cognitive gains in inpatient rehab.
Younger age, female sex, higher motor function, longer stays, and freestanding facilities predicted better recovery. Black and Hispanic patients had lower odds of favorable outcomes.
Key findings
01Patients improved their cognitive scores by an average of 5.25 points during inpatient rehabilitation, exceeding the 3-point threshold for clinically meaningful gain.
02Female sex, higher motor function at admission, longer length of stay, and discharge from a freestanding facility were associated with increased odds of favorable cognitive recovery.
03Black and Hispanic or Latino patients had significantly lower odds of favorable cognitive recovery compared to white patients.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study lacked direct measures of injury severity, relying instead on days from onset to admission, which may not fully explain differences between facility types. Data on specific cognitive profiles, acute care rehabilitation, and pre-injury functioning were unavailable. The sample over-represented white patients and under-represented Black and Hispanic patients compared to national census data. The Functional Independence Measure may not detect subtle cognitive gains in patients who start with higher function.
Declared interests
The study was supported by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR).
The easy way to misread this
Do not interpret the lower odds of favorable recovery in accredited facilities as evidence that accreditation harms patients. This likely reflects that accredited facilities treat more severe or complex cases, which the study could not fully adjust for due to a lack of direct injury severity measures.