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Predictors of cognitive gains during inpatient rehabilitation for older adults with traumatic brain injury.

Publication ,  Journal Article
Byom, L; Zhao, AT; Yang, Q; Oyesanya, T; Harris, G; Cary, MP; Bettger, JP
Published in: PM R
March 2023

INTRODUCTION: Traumatic brain injury (TBI) among older adults is increasing and can affect cognition. To effectively meet the rehabilitation needs of older adults, a clearer picture is needed of patient-, clinical-, and facility-level characteristics that affect cognitive recovery during inpatient rehabilitation facility (IRF) stays. OBJECTIVE: To identify patient, clinical, and facility factors associated with cognitive recovery among older adults with TBI who received IRF care. DESIGN: Secondary data analysis. SETTING: Uniform Data System for Medical Rehabilitation-participating IRFs in the United States. PATIENTS: Patients were 65 to 99 years of age at IRF admission for TBI. Participants received IRF care between 2002 and 2018 (N = 137,583); 56.3% were male; 84.2% were white; mean age was 78.7 years. MAIN OUTCOME MEASURE: Change in Functional Independence Measure Cognitive Score (FIM-Cognitive) from IRF admission to discharge, categorized as favorable (FIM-cognitive score gains ≥3 points) or poor (FIM-cognitive score gains <3 points) cognitive outcomes. INTERVENTIONS: Not applicable. RESULTS: Patients had greater odds of favorable cognitive recovery if they were female (adjusted odds ratio [aOR] 1.05, 95% confidence interval [CI] 1.05-1.08), had higher motor functioning at IRF admission (aOR 1.03, 95% CI 1.03-1.04), longer length of stay (aOR 1.07, 95% CI 1.06-1.07), or received care at a freestanding IRF (vs. hospital rehab unit) (aOR 1.57, 95% CI 1.52-1.61). Patients who were older (aOR 0.99, 95% CI 0.98-0.99), Black (aOR 0.79, 95% CI 0.75-0.83), Hispanic or Latino (aOR 0.97, 95% CI 0.91-1.02), or were part of another racial or ethnic group (aOR 0.85, 95% CI 0.81-0.90) (vs. White), had high-cost comorbid conditions (aOR 0.71, 95% CI 0.65-0.76), or who had higher cognitive functioning at IRF admission (aOR 0.90, 95% CI 0.90-0.91) had lower odds of favorable cognitive recovery. CONCLUSIONS: Patient (age, sex, race, ethnicity), clinical (level of functioning at IRF admission, length of stay) and facility (e.g., freestanding IRF) factors contributed to the cognitive recoveries of older adults during IRF stays.

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Published In

PM R

DOI

EISSN

1934-1563

Publication Date

March 2023

Volume

15

Issue

3

Start / End Page

265 / 277

Location

United States

Related Subject Headings

  • United States
  • Treatment Outcome
  • Retrospective Studies
  • Rehabilitation Centers
  • Recovery of Function
  • Patient Discharge
  • Male
  • Length of Stay
  • Inpatients
  • Humans
 

Citation

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Byom, L., Zhao, A. T., Yang, Q., Oyesanya, T., Harris, G., Cary, M. P., & Bettger, J. P. (2023). Predictors of cognitive gains during inpatient rehabilitation for older adults with traumatic brain injury. PM R, 15(3), 265–277. https://doi.org/10.1002/pmrj.12795
Byom, Lindsey, Amy T. Zhao, Qing Yang, Tolu Oyesanya, Gabrielle Harris, Michael P. Cary, and Janet Prvu Bettger. “Predictors of cognitive gains during inpatient rehabilitation for older adults with traumatic brain injury.PM R 15, no. 3 (March 2023): 265–77. https://doi.org/10.1002/pmrj.12795.
Byom L, Zhao AT, Yang Q, Oyesanya T, Harris G, Cary MP, et al. Predictors of cognitive gains during inpatient rehabilitation for older adults with traumatic brain injury. PM R. 2023 Mar;15(3):265–77.
Byom, Lindsey, et al. “Predictors of cognitive gains during inpatient rehabilitation for older adults with traumatic brain injury.PM R, vol. 15, no. 3, Mar. 2023, pp. 265–77. Pubmed, doi:10.1002/pmrj.12795.
Byom L, Zhao AT, Yang Q, Oyesanya T, Harris G, Cary MP, Bettger JP. Predictors of cognitive gains during inpatient rehabilitation for older adults with traumatic brain injury. PM R. 2023 Mar;15(3):265–277.
Journal cover image

Published In

PM R

DOI

EISSN

1934-1563

Publication Date

March 2023

Volume

15

Issue

3

Start / End Page

265 / 277

Location

United States

Related Subject Headings

  • United States
  • Treatment Outcome
  • Retrospective Studies
  • Rehabilitation Centers
  • Recovery of Function
  • Patient Discharge
  • Male
  • Length of Stay
  • Inpatients
  • Humans