Evidence for a multidomain clinical assessment of mild traumatic brain injury in older adults.

IF 1.4 4区心理学 Q4 CLINICAL NEUROLOGY

Applied Neuropsychology-Adult Pub Date : 2025-05-01 Epub Date: 2023-06-08 DOI:10.1080/23279095.2023.2218512

Natalie S Sherry, Alicia Kissinger-Knox, Lisa Manderino, Shawn Eagle, Anne Mucha, Michael W Collins, Anthony P Kontos

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引用次数: 0

Abstract

Background: There are few guidelines on the appropriate clinical tools to evaluate mTBI in older adults.

Objective: We aimed to investigate the utility of a multidomain assessment to differentiate older adults with mTBI from controls.

Methods: Participants included 68 older adults (37% male) aged 60-76 (M = 66.24, SD = 4.50) years. Thirty-four patients were diagnosed with a mTBI at a specialty mTBI clinic within 90 days of injury, and age- and sex-matched to 34 community controls. Participants completed the following assessments: Post-Concussion Symptom Scale (PCSS), Short Fall Efficacy Scale-International (Short FES-I), Generalized Anxiety Disorder-7 Item Scale (GAD-7), Geriatric Depression Scale-5 Item (GDS-5), Wide Range Achievement Test-Fourth Edition (WRAT-4) reading subtest, subtests of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), clock drawing, and Vestibular/Ocular Motor Screening for Concussion (VOMS). Independent-samples t-tests or chi-squared analyses were used to compare assessment results between groups. A logistic regression (LR) was conducted to determine which combination of assessments best identified the mTBI group from controls.

Results: The mTBI group endorsed significantly more symptoms of concussion (p < .001), balance concerns (p < .001), anxiety (p < .001), and depression (p = 0.04), and performed worse on cognitive (p < .001), vestibular (p < .001), and oculomotor (p = .004) screening relative to controls. The LR (p < .001; r² = 0.90) correctly identified 98.5% of older adults and retained concussion (p = .01) and depression (p = .02) symptoms, and cognitive (p = .03) and vestibular (p = .04) screening in the final model.

Discussion: The current findings support a multidomain assessment model of care for evaluating mTBI in older adults.

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老年人轻度创伤性脑损伤的多领域临床评估证据。

背景:关于评估老年人mTBI的合适临床工具的指南很少。目的:我们旨在研究多领域评估的效用，以区分老年mTBI患者和对照组。方法:参与者包括68名60-76岁的老年人(37%男性)(M = 66.24, SD = 4.50)。34名患者在受伤后90天内在mTBI专科诊所被诊断为mTBI，年龄和性别与34名社区对照相匹配。参与者完成了以下评估:脑震荡后症状量表(PCSS)、短跌倒效果量表-国际(Short FES-I)、广泛性焦虑障碍-7项量表(GAD-7)、老年抑郁量表-5项量表(GDS-5)、广泛成就测试-第四版(WRAT-4)阅读子测试、神经心理状态评估可重复测试(rban)子测试、时钟绘制和脑震荡前庭/眼运动筛查(VOMS)。采用独立样本t检验或卡方分析比较组间评估结果。进行逻辑回归(LR)以确定哪种评估组合最能从对照组中识别出mTBI组。结果:与对照组相比，mTBI组有更多的脑震荡症状(p p p = 0.04)，在认知筛查方面表现更差(p p p = 0.004)。在最终模型中，LR (p r2 = 0.90)正确识别了98.5%的老年人，并保留了脑震荡(p = 0.01)和抑郁(p = 0.02)症状，以及认知(p = 0.03)和前庭(p = 0.04)筛查。讨论:目前的研究结果支持一个多领域的护理评估模型来评估老年人mTBI。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Applied Neuropsychology-Adult CLINICAL NEUROLOGY-PSYCHOLOGY

CiteScore

4.50

自引率

11.80%

发文量

134

期刊介绍： pplied Neuropsychology-Adult publishes clinical neuropsychological articles concerning assessment, brain functioning and neuroimaging, neuropsychological treatment, and rehabilitation in adults. Full-length articles and brief communications are included. Case studies of adult patients carefully assessing the nature, course, or treatment of clinical neuropsychological dysfunctions in the context of scientific literature, are suitable. Review manuscripts addressing critical issues are encouraged. Preference is given to papers of clinical relevance to others in the field. All submitted manuscripts are subject to initial appraisal by the Editor-in-Chief, and, if found suitable for further considerations are peer reviewed by independent, anonymous expert referees. All peer review is single-blind and submission is online via ScholarOne Manuscripts.