Informant's perceptions and objective cognitive decline among Mexican older adults with a history of traumatic brain injury with and without loss of consciousness

• Published in: Alzheimer's & dementia Vol. 16
• Main Authors: Piña‐Escudero, Stefanie Danielle, de Jesús García Aviles, Roberto, Chodos, Anna H., Ritchie, Christine S., Avila, Jose Alberto
• Format: Journal Article
• Language: English
• Published: 01.12.2020
• ISSN: 1552-5260; 1552-5279
• DOI: 10.1002/alz.044666

Background Traumatic Brain Injury (TBI) is extremely common across the lifespan and is an established risk factor for dementia, including Alzheimer's disease. However, the effect of TBI with loss of consciousness (LOC) history on cognitive change with aging and how it is perceived by caregivers are poorly understood. Methods Cross‐sectional study analyzing 1681 community‐dwelling older adults from the MHAS‐Cognitive Aging Ancillary Study. TBI status (control, TBI without LOC and TBI with LOC) was defined by an affirmative answer to the questions: “Have you ever hurt your head or neck in an accident?” and “Did you lost consciousness as a result of the injury?”. Cognition was measured by a global cognitive score (GCS) that comprised the sum of six cognitive domains. Informants' cognitive perception scores were measured with the Community Screening Instrument for Dementia (CSID). For analysis, chi square and ANOVA were used to describe the sample. Linear regression models adjusting for age, sex, years education, number of comorbidities, functionality and depressive symptoms were built to test the association between TBI status and cognitive scores as well as TBI status and CSDI scores. Results The mean age of the population was 68(+8.6) years, 68% were women, the mean of years of education was 5.5(+4.4), and 14.6% had history of LOC. Simple linear regression models showed a positive association between TBI status and GCS status (β=‐0.078, p=0.001). This association was also observed with the following cognitive domains: orientation (β=‐0.053, p=0.28), immediate recall (β=‐0.088, p=<0.001), delayed recall (β=‐0.073, p=0.003), attention (β=‐0.062, p=0.011) and executive function (β=‐0.06, p=0.010). A significant association with CSID scores was also revealed (β=0.131, p=<0.001) and it was the only association that remained significant after adjustment (β=0.073, p=<0.001). Conclusion Findings from this study suggest that TBI with LOC is not independently associated with cognitive scores in older adults. However, TBI with LOC is significantly associated with CSDI scores even after adjustment. Informant's perceptions reflect that LOC might have and influence in the cognitive skills that older adults use in their everyday life that testing could not accurately capture in a population with low education.