Cognitive profiles of older adults with a prior traumatic brain injury versus healthy controls: A meta-analysis

Abstract

Objective: To determine cognitive outcomes in older adults (≥ 50 years old) having sustained a traumatic brain injury (TBI) using meta-analysis.

Methods: MedLine and PsycInfo databases were searched to identify studies comparing neuropsychological profiles in older adults with and without a history of TBI across various injury severities and times post-injury. Ten studies (n = 717) meeting inclusion criteria were identified. Tests were divided into functional modalities and average effect sizes were calculated across studies on a test-by-test basis.

Results: Older adults post-TBI performed worse than the non-TBI group on all cognitive outcomes evaluated (d = -0.34 to -0.75), with naming and vocabulary having the largest effect, M -0.75 (95% CI, -0.98 to -0.52).

Conclusions: TBI in older adults leads to moderate deficits on all measured cognitive abilities, with the largest effects observed in naming and vocabulary abilities. The findings pertain broadly to TBI of mixed injury severities and times post-injury, although the majority of participants sustained TBIs of mild uncomplicated severity within one-year post-injury. Future research must address methodological limitations such as variability in reporting injury information, inconsistency in defining older age, and lack of orthopaedic comparison groups in order to permit more nuanced conclusions for this population.

Keywords: TBI; cognitive domains; cognitive profiles; neuropsychological tests; older adults; traumatic brain injury.