All ETDs from UAB

Advisory Committee Chair

Kristen L Triebel

Advisory Committee Members

Thomas Novack

Michael Crowe

Richard Kennedy

Document Type

Thesis

Date of Award

2017

Degree Name by School

Master of Arts (MA) College of Arts and Sciences

Abstract

Objective: To examine whether cognitive reserve (CR) attenuates the initial impact of TBI on cognitive performance (passive model) and results in faster cognitive recovery rates in the first year post-injury (active model), and whether the advantage of CR differs based on the severity of TBI. Setting: Inpatient/outpatient clinics at academic medical center. Participants: Adults with mild TBI (mTBI; n=28), complicated mild TBI (cmTBI; n=24), and moderate-to-severe TBI (msevTBI; n=57), and demographically-matched controls (n=66). Design: Retrospective; longitudinal cohort assessed at 1-, 6-, and 12-months post-injury. Main Measures: Outcomes were 3 cognitive domains: processing speed/executive function, verbal fluency, and memory. Premorbid IQ, estimated with the Wechsler Test of Adult Reading, served as CR proxy. Results: Higher premorbid IQ was associated with better performance on cognitive domains at one-month post-injury, and the effect of IQ was similarly beneficial for all groups. Cognitive recovery rate was moderated only by TBI severity; those with more severe TBI had faster recovery in the first year. Conclusion: Results provide evidence for the passive, but not active, model of CR during TBI recovery. Specifically, the mechanism for the passive model is preservation of the pre-injury relationship between CR and cognition. CR does not moderate the rate of recovery.

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