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Head injury at different ages and cognitive performance in a diverse cohort: Findings from the KHANDLE Study
Author(s) -
Nuno Miriam,
Gilsanz Paola,
Glymour M. Maria,
Mayeda Elizabeth Rose,
Eng Chloe W.,
Peterson Rachel,
George Kristen M.,
Mungas Dan M.,
DeCarli Charles,
Whitmer Rachel A.
Publication year - 2020
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.046619
Subject(s) - head injury , cognition , medicine , neuropsychology , interquartile range , cohort , verbal memory , episodic memory , cognitive reserve , neuropsychological assessment , gerontology , clinical psychology , psychology , cognitive impairment , psychiatry , surgery
Background Evidence is limited on the impact of a head injury and the role of age at injury on different cognitive domains, particularly among in diverse cohorts. Methods The Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) study examines cognitive aging across four racial/ethnic groups (29% White, 26% Black, 24% Asian, & 20% Latino). Head injury was determined by asking: “Have you ever had a head injury where you lost consciousness or for which you received medical care?” Age at first injury was grouped as 0‐15, 16‐29, 30‐64 and 65+ years. Education was coded as college graduate or more and less than college graduate. Z‐standardized measures of verbal episodic memory, semantic memory, and executive function were assess using the Spanish and English Neuropsychological Assessment Scales (SENAS). The association between head injury and cognitive domains were analyzed with adjustment for age, sex, race, and education using multivariable linear regression models. Results Among the analytic sample of 1,666 participants, 392 (22.9%) reported history of a head injury. Exposure to head injury was not associated with deficits in executive function (β=0.04, 95% CI: −0.05, 0.14), verbal episodic memory (β=‐0.09, 95% CI: −0.02, 0.10), or semantic memory (β=0.07, 95% CI: −0.02, 0.16). Among those reporting a head injury, 77.1% experienced one injury, 15.5% 2 injuries, 4.6% 3 injuries, and 6.7% participants reported 4+ injuries. The median (interquartile range) age at first head injury was 24 (13‐60) years, and time since first head injury was 48 (14‐61) years. Age at first head injury was not associated with cognitive function when compared to individuals without a head injury (Table 1A). Among those with a history of head injury, age at first injury was not associated with executive function (65+ vs. 0‐15 years: β=‐0.25, 95% CI: −0.50, 0.01), verbal episodic memory (65+ vs. 0‐15 years: β=0.21, 95% CI: −0.05, 0.47), or semantic memory (65+ vs. 0‐15 years: β=‐0.09, 95% CI: −0.32, 0.13) (Table 1B). Conclusion Participants who reported a head injury did not exhibit worse cognition compared to those without history of injury nor was age at first head injury associated with any cognitive domain.