Three or more concussions linked with worse brainfunction in later life uniofexeter
) and thus recommendations should indicate that each additional mTBI increases risk of substantial cognitive decline. As previously mentioned, there was no greater decline in cognitive scores with time in this study for those with higher numbers of mTBIs, suggesting that in the chronic phase mTBI causes a dose-dependent, fixed cognitive deficit.Interestingly, those in the Non-TBI Head Strike or mTBI group had significantly better episodic memory compared with those who had no head injuries.
The main limitations of this study include missing data, unmeasured confounders, retrospective recall of injuries, challenges with follow-up, and difficulties with domain interpretation. There are a number of unmeasured covariates such as lower socioeconomic status, physical health, and history of alcohol/drug use that are known to affect cognitive scores and to be associated with higher rates of TBI, potentially confounding the results.
The longitudinal follow-up at 4 years was 45.3%, although a significant loss to follow-up it is comparable to other longitudinal studies of ageing. This issue of missing follow-up data was mitigated using the LMM design. Although the PCA is a useful tool for reducing dimensionality, the domains produced are imperfect constructs. For the domain of executive function both the TMTB and Stroop switching task are timed and partly reflect processing speed.
Author contributions are as follows. Matthew Lennon: methodology, formal analysis, visualization, writing the original draft, and review and editing drafts. Helen Brooker: conceptualization, data curation, methodology, project administration, software, supervision, data validation and verification and review and editing drafts. Byron Creese: conceptualization, data curation, methodology, project administration, software, supervision, validation, and review and editing drafts.
The study sponsors provided funding but otherwise the design, collection, analysis, and interpretation of data, the writing of the report, and the decision to submit the article for publication, were performed by the funded researchers independent of the funding bodies.Clive Ballard collected consulting fees from the following companies: Acadia, AARP, Addex, Biohaven, Eli Lily and Company, Enterin Inc., Exciva, H. Lundbeck A.S., Janssen Pharmaceuticals, Novo Nordisk, Orion Corp.
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