Cognitive, behavioral, and functional outcomes of suspected mild traumatic brain injury in community‐dwelling older persons without mild cognitive impairment or dementia
Bibliographic record
Abstract
Abstract Background Traumatic brain injury (TBI) is a risk factor for dementia and is linked to earlier age of onset. This study investigated whether later‐life changes in everyday cognition and behavior – risk markers of AD – could be observed in cognitively unimpaired older persons who sustained suspected mild TBI (smTBI) earlier in life and whether these cognitive and behavioral changes behavior mediated the link between smTBI and daily function. Method Data for 1274 participants from the Canadian Platform for Research Online to Investigate Health, Quality of Life, Cognition, Behaviour, Function, and Caregiving in Aging (CAN‐PROTECT) study were analyzed. A self‐reported brain injury screening questionnaire was used to determine smTBI. Outcomes were measured using the Everyday Cognition (ECog‐II) scale, MBI Checklist (MBI‐C), and Standard Assessment of Global Everyday Activities (SAGEA). SCD was operationalized based on a score of ≥2 (i.e., consistently a little or much worse) on any ECog‐II item. MBI+ status was defined by MBI‐C total scores ≥8. Age, sex, years of education, marital status, and ethnocultural origin were balanced across exposure groups using inverse probability of treatment weighting. Weighted logistic and negative binomial regressions were used to model smTBI (exposure) associations with SCD and MBI+ statuses, and ECog‐II and MBI‐C total scores, respectively. Result Sample characteristics are shown in Table 1. Sustaining smTBI throughout the life course was linked to a higher odds of participants reporting SCD or MBI, as well as higher ECog‐II or MBI‐C total scores [Table 2]. Finally, SCD partially mediated, whereas MBI+ fully mediated, the association between smTBI and SAGEA total scores; SCD and MBI+ statuses accounted for approximately 45% and 70% of the total effect, respectively [Table 3]. Conclusion Sustaining smTBI throughout the life course is linked to poorer cognition and behavior even in community‐dwelling older persons without MCI or dementia. Older persons with smTBI may benefit from early dementia risk assessment using tools that measure changes in cognition and behavior. Interventions for declining cognition and behavior may also be beneficial in this population to address functional impairment.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".