Cognitive reserve among elderly patients with traumatic brain injury



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Abstract

BACKGROUND: Traumatic brain injury (TBI) is damage to the brain caused by an external mechanical force, leading to temporary or permanent impairment of brain function and associated with deficits in information processing speed, attention, memory, speech, visuospatial perception, and executive functions. Cognitive reserve is defined as inherited or acquired mental skills that provide higher cognitive adaptability and protect against the effects of brain aging, diseases, or injuries; however, it remains insufficiently studied in patients with TBI.

AIM: The work aimed to examine the characteristics of cognitive reserve in elderly patients with traumatic brain injury.

METHODS: Fifty-seven individuals aged 60–74 years with TBI and 60 patients of the same age without brain injury were examined. Cognitive reserve was assessed using the Cognitive Reserve Index questionnaire, which includes questions on education, occupational activity, and leisure time. Mental status was evaluated using the MoCA and MMSE scales.

RESULTS: Comparison between elderly TBI patients and age-matched controls showed that the overall cognitive reserve index was higher in the control group. Among 60–74-year-old TBI patients, the cognitive reserve index was significantly higher in those with mild TBI and lowest in those with severe TBI (p < 0.001). Positive correlations were found between “driving a car” (r = 0.315, p < 0.05) and “use of modern technologies” (r = 0.300, p < 0.05) in elderly patients without trauma. At the same time, these characteristics were negatively correlated with moderate TBI (r = −0.273, p < 0.05 and r = −0.404, p < 0.05, respectively).

CONCLUSION: Cognitive reserve makes a substantial contribution to the clinical profile of TBI in older age. The results demonstrated that cognitive reserve is associated with TBI severity, with more severe injuries corresponding to a lower cognitive reserve index.

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About the authors

Anastasia S. Lysenko

Belgorod State National Research University

Email: anastasiya-lysenko-96@mail.ru
ORCID iD: 0009-0001-9205-0122
Russian Federation, Belgorod

Nikolay M. Agarkov

Belgorod State National Research University; Southwest State University; S.N. Fedorov National Medical Research Center «MNTK Eye Microsurgery»

Author for correspondence.
Email: vitalaxen@mail.ru
ORCID iD: 0000-0002-4821-3692
SPIN-code: 8921-6603

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Belgorod; Kursk; Tambov

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2. Fig. 1. Integral cognitive reserve index in patients with mild (1), moderate (2), severe (3) traumatic brain injury and in the control group (4). * p <0.01 between patients with mild and moderate traumatic brain injury, ** p <0.01 between patients with mild and severe traumatic brain injury, # p <0.05 between patients with moderate and severe traumatic brain injury, *** p <0.01 between patients with moderate, severe traumatic brain injury and those in the control group.

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3. Fig. 2. The average score of cognitive impairment on the MMSE scale in patients with mild (1), moderate (2), severe (3) traumatic brain injury and in the control group (4). * p <0.01 between patients with mild and moderate traumatic brain injury, ** p <0.001 between patients with mild and severe traumatic brain injury, # p <0.01 between patients with moderate and severe traumatic brain injury, *** p <0.01 between patients with moderate, severe traumatic brain injury and those in the control group.

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4. Fig. 3. Indicators of cognitive impairment on the MoCA scale in patients with mild (1), moderate (2), severe (3) traumatic brain injury and in the control group (4). * p <0.01 between patients with mild and moderate traumatic brain injury, ** p <0.001 between patients with mild and severe traumatic brain injury, # p <0.05 between patients with moderate and severe traumatic brain injury, *** p <0.01 between patients with moderate, severe traumatic brain injury and those in the control group.

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