Cognitive reserve among elderly patients with traumatic brain injury

BACKGROUND.  A traumatic brain injury is a brain injury caused by an external mechanical impact that leads to temporary or permanent impairment of brain functions, and is associated with impaired information processing speed, attention, memory, speech, visual–spatial 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, disease, or injury, but it has not been sufficiently studied in patients with traumatic brain injury.

AIMS: to study the features of cognitive reserve in elderly patients with traumatic brain injury.

MATERIALS AND METHODS. 57 people aged 60-74 with traumatic brain injury and 60 patients of the same age without injury were examined. To assess the cognitive reserve, the Cognitive reserve index questionnaire methodology was used, which includes questions about education, professional activity, and free time (leisure). The examination of the mental state was carried out according to the MoCa and MMSE scales.

RESULTS. When comparing the results of elderly patients with traumatic brain injury and those of a similar age without injury, the overall cognitive reserve index was higher in the control group. Among patients aged 60-74 years with traumatic brain injury, the cognitive reserve index was statistically significantly higher in those with mild severity, and the lowest in those with severe (p<0,001). A positive correlation was obtained between the parameters "driving a car" (r=0,315, p<0,05) and "using modern technologies" (r=0,300, p<0,05) and elderly patients without injury. At the same time, these characteristics were negatively associated with patients with moderate TBI (r=-0,273, p<0,05) and (r=-0,404, p<0,05), respectively.

CONCLUSION. Cognitive reserve makes a significant contribution to the clinical characterization of traumatic brain injury in old age. The results demonstrated that cognitive reserve is correlated with the degree of traumatic brain injury, and the more severe it is, the lower the cognitive reserve index.