Article

OBJECTIVE: To investigate whether the cognitive reserve hypothesis helps to
explain differential cognitive impairment among survivors of traumatic brain
injury (TBI), whereby survivors with greater intellectual enrichment (estimated
with education) are less vulnerable to cognitive impairment. DESIGN:
Cross-sectional study. SETTING: Medical rehabilitation research center.
PARTICIPANTS: Survivors of moderate or severe TBI (n=44) and healthy controls
(n=36). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Intellectual
enrichment was estimated with educational attainment. Group was defined as TBI or
healthy control. Current cognitive status (processing speed, working memory,
episodic memory) was evaluated with neuropsychological tasks. RESULTS: TBI
survivors exhibited worse cognitive status than healthy persons (P<.001), and
education was positively correlated with cognitive status in TBI survivors
(r=.54, P<.001). Most importantly, regression analysis revealed an interaction
between group and education (R(2) change=.036, P=.004), whereas higher education
attenuated the negative impact of TBI on cognitive status. TBI survivors with
lower education performed much worse than matched healthy persons, but this
TBI-related performance discrepancy was attenuated at higher levels of education.
CONCLUSIONS: Higher intellectual enrichment (estimated with education) reduces
the negative effect of TBI on cognitive outcomes, thereby supporting the
cognitive reserve hypothesis in persons with TBI. Future work is necessary to
investigate whether intellectual enrichment can build cognitive reserve as a
rehabilitative intervention in survivors of TBI.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS