Understanding multidimensional apathy in traumatic brain injury.

IF 3.7 2区 医学 Q1 REHABILITATION
Meg Rankin, Jennie Ponsford, Amelia Hicks, Ruby Phyland, Trevor T-J Chong, Gershon Spitz
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引用次数: 0

Abstract

Objective: To investigate whether individuals with moderate-to-severe chronic TBI exhibit higher levels of apathy-particularly in behavioural, cognitive, and emotional domains-compared to neurotypical controls, and examine the association between apathy severity and injury-related factors, productivity and quality of life.

Design: Cross-sectional, cohort study.

Setting: Community.

Participants: Participants were sampled from a larger longitudinal study of individuals recruited from consecutive inpatient TBI admissions to a rehabilitation hospital. We analysed data from 136 participants with moderate-to-severe TBI (53% male; MAge = 51.8 years; Mtime post-injury = 13.8 years, range 0.25-35.2) and 78 neurotypical controls (48.75% male; MAge = 50.3 years).

Interventions: Not applicable.

Main outcome measures: Apathy Evaluation Scale, injury-related measures, Satisfaction with Life Scale, coded Productivity measure based on employment status.

Results: Results indicated that individuals with TBI had significantly higher overall apathy (p = 0.031) and behavioural apathy (p = 0.037) compared to neurotypical controls, but did not differ in the cognitive or emotional subtypes. Individuals with TBI were 1.98 times more likely to exhibit clinically significant apathy (OR = 1.98, 95% CI [0.98, 4.22]). Glasgow Coma Scale score, post-traumatic amnesia duration, age at the time of injury, time post-injury, and abnormal computed tomography scan were not significantly related to any apathy subtype. Higher global apathy scores were significantly associated with lower productive activities (p = 0.021), while higher global and behavioural apathy were significantly associated with lower life satisfaction (p <.001, p = 0.021, respectively).

Conclusions: These findings underscore the elevated prevalence of apathy following TBI, which may manifest primarily in the behavioural domain. The association between elevated apathy and lower functioning and reduced life satisfaction highlights that apathy is a key factor influencing long-term outcomes. Identifying and addressing apathy, especially its behavioural component, may therefore be critical for improving functional recovery and quality of life in this population.

了解外伤性脑损伤的多维冷漠。
目的:研究中重度慢性TBI患者是否表现出更高水平的冷漠,特别是在行为、认知和情绪领域,并研究冷漠严重程度与损伤相关因素、生产力和生活质量之间的关系。设计:横断面、队列研究。设置:社区。参与者:参与者从一个更大的纵向研究中抽样,该研究从康复医院连续住院的TBI患者中招募。我们分析了136名中重度TBI患者(53%男性;MAge = 51.8岁;时光网损伤后 = 13.8岁,范围0.25-35.2岁)和78名神经正常对照组(48.75%男性;MAge = 50.3岁)的数据。干预措施:不适用。主要结果测量:冷漠评估量表,伤害相关测量,生活满意度量表,基于就业状况的编码生产力测量。结果:结果表明,与神经正常对照组相比,TBI患者的整体冷漠(p = 0.031)和行为冷漠(p = 0.037)明显更高,但在认知或情绪亚型上没有差异。脑外伤患者表现出临床意义上的冷漠的可能性是其他患者的1.98倍(OR = 1.98,95% CI[0.98, 4.22])。格拉斯哥昏迷量表评分、创伤后健忘症持续时间、损伤时年龄、损伤后时间、计算机断层扫描异常与任何冷漠亚型均无显著相关性。较高的整体冷漠得分与较低的生产活动显著相关(p = 0.021),而较高的整体和行为冷漠得分与较低的生活满意度显著相关(p结论:这些发现强调了创伤性脑损伤后冷漠患病率的升高,这可能主要表现在行为领域。冷漠升高与功能低下和生活满意度降低之间的联系突出表明,冷漠是影响长期结果的关键因素。因此,识别和解决冷漠,特别是其行为成分,可能对改善这一人群的功能恢复和生活质量至关重要。
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来源期刊
CiteScore
6.20
自引率
4.70%
发文量
495
审稿时长
38 days
期刊介绍: The Archives of Physical Medicine and Rehabilitation publishes original, peer-reviewed research and clinical reports on important trends and developments in physical medicine and rehabilitation and related fields. This international journal brings researchers and clinicians authoritative information on the therapeutic utilization of physical, behavioral and pharmaceutical agents in providing comprehensive care for individuals with chronic illness and disabilities. Archives began publication in 1920, publishes monthly, and is the official journal of the American Congress of Rehabilitation Medicine. Its papers are cited more often than any other rehabilitation journal.
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