VA San Diego Healthcare System, San Diego, California (Mr Rantins, Drs Ly, Merritt, Bangen, and Thomas and Ms Alshaheri Durazo); San Diego State University, San Diego, California (Mr Rantins and Ms Alshaheri Durazo); Department of Psychiatry, University of California, San Diego, La Jolla (Drs Ly, Merritt, Bangen, and Thomas); Department of Psychology, University of Texas at Austin, Austin (Dr Clark); Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego (Ms Weigand); Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, California (Dr Merritt).
J Head Trauma Rehabil. 2024;39(3):239-246. doi: 10.1097/HTR.0000000000000897. Epub 2023 Sep 8.
This study examined the moderating effect of traumatic brain injury (TBI) history on subjective and objective cognition across multiple cognitive domains.
SETTING, PARTICIPANTS, AND DESIGN: Participants included 242 Vietnam-era veterans with a history of no TBI (n = 86), mild TBI (n = 74), or moderate-to-severe TBI (n = 82) from the observational Department of Defense-Alzheimer's Disease Neuroimaging Initiative (DoD-ADNI) study.
Objective cognition was the outcome and was measured using neuropsychological measures in the domains of memory, attention/executive functioning, and language. Subjective cognition was measured using the memory, divided attention, and language subscales from the Everyday Cognition (ECog) measure. TBI severity status was the moderating variable.
Veterans with a history of moderate-to-severe TBI had a stronger negative association between subjective and objective attention relative to participants without a TBI ( P = .002). Although this association did not differ between mild TBI and no TBI history groups ( P = .100), the association between subjective and objective attention for the mild TBI group was intermediate to the no TBI and moderate-to-severe TBI history groups. TBI status did not moderate associations between subjective and objective memory or language.
Results highlight the importance of assessing subjective and objective cognition in older veterans and the relevance of attention in the context of TBI history. More work is needed to better understand the intersection of TBI and aging and how these factors may be used to guide individualized assessment and treatment approaches for older veterans.
本研究考察了创伤性脑损伤（TBI）史对多个认知领域的主观和客观认知的调节作用。
设置、参与者和设计：参与者包括来自观察性国防部-阿尔茨海默病神经影像学倡议（DoD-ADNI）研究的 242 名无 TBI（n=86）、轻度 TBI（n=74）或中重度 TBI（n=82）的越南时代退伍军人。
客观认知是结果，使用记忆、注意力/执行功能和语言领域的神经心理学测量来衡量。主观认知使用日常认知（ECog）测量的记忆、分散注意力和语言分量表进行衡量。TBI 严重程度是调节变量。
有中重度 TBI 史的退伍军人主观和客观注意力之间的负相关性比无 TBI 史的退伍军人更强（P=0.002）。尽管这种关联在轻度 TBI 和无 TBI 史组之间没有差异（P=0.100），但轻度 TBI 组的主观和客观注意力之间的关联处于无 TBI 和中重度 TBI 史组之间。TBI 状态并未调节主观和客观记忆或语言之间的关联。
结果强调了在老年退伍军人中评估主观和客观认知的重要性，以及在 TBI 史背景下注意力的相关性。需要做更多的工作来更好地理解 TBI 和衰老的交叉点，以及这些因素如何用于指导老年退伍军人的个体化评估和治疗方法。
