Cognitive deficits four decades after traumatic brain injury in Australian Vietnam war veterans

Tia L. Cummins, Alby Elias, F. Lamb, C. Rowe, J. Ponsford, M. Hopwood, Victor Villemagne
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引用次数: 1

Abstract

Objective: Since 2000, over 350,000 US military personnel have been diagnosed with a traumatic brain injury (TBI) (VA, 2010). Whilst epidemiological studies report up to a fourfold increased risk for dementia associated with brain injury amongst veterans there is limited controlled research into the long-term neuropsychological burden of injury. Main aim: The study aimed to determine whether Australian Vietnam war veterans with service-related TBI were more likely to exhibit cognitive deficits, 30-50 years after injury when compared to healthy veteran controls. Materials and methods: 69 male veterans 60-85 years old, underwent psychiatric and neuropsychological assessment; 40 with a TBI (mean age = 68.0 ± 2.5) and 29 without (mean age = 70.1 ± 5.3). The TBI cohort included 15 mild, 16 moderate and nine severe TBI. Results: After adjustment for identified covariates, veterans with moderate-to-severe TBI performed significantly worse than controls on composite measures of memory and learning (M = -0.55 ± 0.69, t(67) = 2.86, p=0.006, d=0.70) and attention and processing speed (M = -0.71 ± 1.08, t(52) = 2.53, p=0.014, d=0.69). There were no differences in cognitive performance between veterans with mild TBI (mTBI) and controls. Conclusion: Results from this study suggest that amongst ageing veterans, a moderate-to-severe TBI sustained during early adulthood is associated with later-life cognitive deficits in memory and learning, attention and processing speed.
澳大利亚越战老兵脑外伤四十年后的认知缺陷
目的:自2000年以来,超过35万美国军人被诊断为创伤性脑损伤(TBI) (VA, 2010)。虽然流行病学研究报告称,退伍军人与脑损伤相关的痴呆风险增加了四倍,但对损伤的长期神经心理负担的对照研究有限。主要目的:该研究旨在确定与健康的退伍军人相比,在受伤后30-50年,患有与服务相关的创伤性脑损伤的澳大利亚越战退伍军人是否更有可能表现出认知缺陷。材料与方法:69例60 ~ 85岁男性退伍军人,行精神病学和神经心理学评估;40例伴有TBI(平均年龄= 68.0±2.5),29例无TBI(平均年龄= 70.1±5.3)。TBI队列包括15例轻度TBI, 16例中度TBI和9例重度TBI。结果:调整确定的协变量后,中重度创伤性脑损伤退伍军人在记忆和学习(M = -0.55±0.69,t(67) = 2.86, p=0.006, d=0.70)和注意力和加工速度(M = -0.71±1.08,t(52) = 2.53, p=0.014, d=0.69)的综合指标上的表现显著低于对照组。轻度创伤性脑损伤(mTBI)退伍军人的认知表现与对照组没有差异。结论:本研究结果表明,在老年退伍军人中,成年早期持续的中度至重度脑外伤与晚年在记忆和学习、注意力和处理速度方面的认知缺陷有关。
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