INS NYC 2024 Program

Poster	Poster Session 05 Program Schedule 02/15/2024 02:30 pm - 03:45 pm Room: Shubert Complex (Posters 1-60) Poster Session 05: Neuropsychiatry \| Addiction/Dependence \| Stress/Coping \| Emotional/Social Processes Final Abstract #35 Prevalence of Low Scores in the Uniform Data Set Version 3: Comparison of Older Adults with and without a Self-Reported History of Traumatic Brain Injury Charles Gaudet, VA Boston Healthcare System, Boston, United States Colleen Jackson, Boston University Chobanian & Avedisian School of Medicine, Boston, United States Michael Alosco, Boston University Chobanian & Avedisian School of Medicine, Boston, United States Category: Acquired Brain Injury (TBI/Cerebrovascular Injury and Disease - Adult) Keyword 1: traumatic brain injury Keyword 2: psychometrics Objective: Objective: To assess for differences in the prevalence of low scores on neuropsychological measures amongst older adults with and without a self-reported history of traumatic brain injury (TBI). Participants and Methods: Participants and Methods: We designed an observational cohort study using the National Alzheimer’s Coordinating Center (NACC) dataset. The study sample included adults age 65 or older for whom English was their primary language, reported no history of alcohol or substance abuse, and completed the Uniform Data Set (UDS) 3 neuropsychological test battery (N=9,259). Lifetime TBI was assessed via a medical history interview; participants were asked whether they had ever experienced a TBI without loss of consciousness (LOC), TBI with <5 minutes LOC, or TBI with ≥5 minutes LOC. Groups included those with (n=907; +TBI) and without (n=6456, -TBI) a remote history of lifetime TBI. Neuropsychological raw scores were converted to z-scores using regression-based procedures that adjusted for age, sex, and education. We compared -TBI and +TBI groups by the prevalence of low scores out of 21 possible UDS 3 scores. Low scores were defined as <1, 1.5, and 2 standard deviations (SD) below the mean. We used criteria adapted from Kiselica et al. (2020) to define atypical performance as the number of low scores obtained by 5% or less of the sample. A hierarchical linear regression assessed for associations among low score prevalence and participant demographics, Global Clinical Dementia Rating (CDR), Geriatric Depression Scale (GDS) score, and TBI history and recency. Exploratory analyses included stratification by prior TBI frequency and severity. Results: Results: The prevalence of low scores (<1, 1.5, and 2 SD below the mean) did not appear to differ between TBI groups. Between 14% and 18% of participants both with and without a history of TBI obtained an atypical number of low scores. Hierarchical regression results indicated that Global CDR and GDS score showed a statistically significant association with low score frequency after accounting for basic demographics (Δ R²=.31); however, TBI history and time since most recent TBI did not contribute unique variance (Δ R²=.00). In the multivariable model, education (b=.03, p<.001), Global CDR (b=.56, p<.001), GDS score (b=.05, p<.001), and time since most recent TBI (b=-.06, p=.010) were associated with the number of low scores. Participants who reported repeated or multiple TBIs with varying degrees of severity (no LOC, brief LOC, & extended LOC) appeared to obtain low scores more frequently than participants who reported a history of a single or no TBI at the most conservative low score threshold (<1 SD). Conclusions: Conclusions: The number of low scores on the UDS 3 did not differ among older adults with and without a self-reported remote history of TBI. However, low score frequency varied secondary to education, Global CDR, GDS, and time since most recent TBI. Participants with a self-reported history of multiple or repeated TBIs appeared to obtain low scores with greater frequency when using a conservative criterion. Further research is indicated to comprehensively characterize these possible modifiers of the association between cognitive functioning and TBI history in older adults.

Poster

02/15/2024
02:30 pm - 03:45 pm
Room: Shubert Complex (Posters 1-60)

Poster Session 05: Neuropsychiatry | Addiction/Dependence | Stress/Coping | Emotional/Social Processes

Final Abstract #35

Prevalence of Low Scores in the Uniform Data Set Version 3: Comparison of Older Adults with and without a Self-Reported History of Traumatic Brain Injury

Charles Gaudet, VA Boston Healthcare System, Boston, United States
Colleen Jackson, Boston University Chobanian & Avedisian School of Medicine, Boston, United States
Michael Alosco, Boston University Chobanian & Avedisian School of Medicine, Boston, United States

Category: Acquired Brain Injury (TBI/Cerebrovascular Injury and Disease - Adult)

Keyword 1: traumatic brain injury
Keyword 2: psychometrics

Objective:

Objective: To assess for differences in the prevalence of low scores on neuropsychological measures amongst older adults with and without a self-reported history of traumatic brain injury (TBI).

Participants and Methods:

Participants and Methods: We designed an observational cohort study using the National Alzheimer’s Coordinating Center (NACC) dataset. The study sample included adults age 65 or older for whom English was their primary language, reported no history of alcohol or substance abuse, and completed the Uniform Data Set (UDS) 3 neuropsychological test battery (N=9,259). Lifetime TBI was assessed via a medical history interview; participants were asked whether they had ever experienced a TBI without loss of consciousness (LOC), TBI with <5 minutes LOC, or TBI with ≥5 minutes LOC. Groups included those with (n=907; +TBI) and without (n=6456, -TBI) a remote history of lifetime TBI. Neuropsychological raw scores were converted to z-scores using regression-based procedures that adjusted for age, sex, and education. We compared -TBI and +TBI groups by the prevalence of low scores out of 21 possible UDS 3 scores. Low scores were defined as <1, 1.5, and 2 standard deviations (SD) below the mean. We used criteria adapted from Kiselica et al. (2020) to define atypical performance as the number of low scores obtained by 5% or less of the sample. A hierarchical linear regression assessed for associations among low score prevalence and participant demographics, Global Clinical Dementia Rating (CDR), Geriatric Depression Scale (GDS) score, and TBI history and recency. Exploratory analyses included stratification by prior TBI frequency and severity.

Results:

Results: The prevalence of low scores (<1, 1.5, and 2 SD below the mean) did not appear to differ between TBI groups. Between 14% and 18% of participants both with and without a history of TBI obtained an atypical number of low scores. Hierarchical regression results indicated that Global CDR and GDS score showed a statistically significant association with low score frequency after accounting for basic demographics (Δ R²=.31); however, TBI history and time since most recent TBI did not contribute unique variance (Δ R²=.00). In the multivariable model, education (b=.03, p<.001), Global CDR (b=.56, p<.001), GDS score (b=.05, p<.001), and time since most recent TBI (b=-.06, p=.010) were associated with the number of low scores. Participants who reported repeated or multiple TBIs with varying degrees of severity (no LOC, brief LOC, & extended LOC) appeared to obtain low scores more frequently than participants who reported a history of a single or no TBI at the most conservative low score threshold (<1 SD).

Conclusions:

Conclusions: The number of low scores on the UDS 3 did not differ among older adults with and without a self-reported remote history of TBI. However, low score frequency varied secondary to education, Global CDR, GDS, and time since most recent TBI. Participants with a self-reported history of multiple or repeated TBIs appeared to obtain low scores with greater frequency when using a conservative criterion. Further research is indicated to comprehensively characterize these possible modifiers of the association between cognitive functioning and TBI history in older adults.