1 Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai , New York, New York.
2 Department of Neurology, Icahn School of Medicine at Mount Sinai , New York, New York.
J Neurotrauma. 2018 May 15;35(10):1138-1145. doi: 10.1089/neu.2017.5347. Epub 2018 Mar 13.
Traumatic brain injury (TBI) often results in cognitive impairment, and trajectories of cognitive functioning can vary tremendously over time across survivors. Traditional approaches to measuring cognitive performance require face-to-face administration of a battery of objective neuropsychological tests, which can be time- and labor-intensive. There are numerous clinical and research contexts in which in-person testing is undesirable or unfeasible, including clinical monitoring of older adults or individuals with disability for whom travel is challenging, and epidemiological studies of geographically dispersed participants. A telephone-based method for measuring cognition could conserve resources and improve efficiency. The objective of this study is to examine the feasibility and usefulness of the Brief Test of Adult Cognition by Telephone (BTACT) among individuals who are 1 and 2 years post-moderate-to-severe TBI. A total of 463 individuals participated in the study at Year 1 post-injury, and 386 participated at Year 2. The sample was mostly male (73%) and white (59%), with an average age of (mean ± standard deviation) 47.9 ± 20.9 years, and 73% experienced a duration of post-traumatic amnesia (PTA) greater than 7 days. A majority of participants were able to complete the BTACT subtests (61-69% and 56-64% for Years 1 and 2 respectively); score imputation for those unable to complete a test due to severity of cognitive impairment yields complete data for 74-79% of the sample. BTACT subtests showed expected changes between Years 1-2, and summary scores demonstrated expected associations with injury severity, employment status, and cognitive status as measured by the Functional Independence Measure. Results indicate it is feasible, efficient, and useful to measure cognition over the telephone among individuals with moderate-severe TBI.
创伤性脑损伤（TBI）常导致认知障碍，幸存者的认知功能轨迹在时间上可能会有很大差异。传统的认知表现测量方法需要面对面地进行一系列客观神经心理学测试，这既费时又费力。在许多临床和研究情况下，面对面测试是不可取或不可行的，包括对行动不便的老年人或残疾患者进行临床监测，以及对地理上分散的参与者进行流行病学研究。一种基于电话的认知测量方法可以节省资源并提高效率。本研究旨在检验电话简易成人认知测试（BTACT）在中重度 TBI 后 1 年和 2 年的个体中的可行性和实用性。共有 463 名参与者在损伤后 1 年参加了研究，386 名参与者在损伤后 2 年参加了研究。该样本主要为男性（73%）和白人（59%），平均年龄为（均值±标准差）47.9±20.9 岁，73%的人经历了创伤后遗忘期（PTA）超过 7 天。大多数参与者能够完成 BTACT 分测验（第 1 年分别为 61-69%和 56-64%，第 2 年分别为 61-69%和 56-64%）；由于认知障碍严重而无法完成测试的人，通过分数推断可以得到 74-79%的样本的完整数据。BTACT 分测验在第 1 年至第 2 年之间显示出预期的变化，综合评分与损伤严重程度、就业状况以及功能独立性测量所测量的认知状态之间存在预期关联。结果表明，在中重度 TBI 患者中通过电话进行认知测量是可行、高效且有用的。
