A recent study reveals that patients with mild traumatic brain injuries are more likely to have cognitive impairment, cognitive decline, or both one year later than people who were not injured.

People who had poor cognitive outcomes were also more likely to have other symptoms such as worry and a lower level of life satisfaction.

“Our results suggest that clinically meaningful poor cognitive outcomes, which we defined as cognitive impairment, cognitive decline or both, one year after a concussion may be more common than previously thought,” says study author Raquel Gardner. “They also highlight the need to better understand the mechanisms underlying poor cognitive outcome, even after relatively mild brain injuries, to improve therapy for recovery.”

The research included 656 individuals with concussions who were admitted to trauma centers’ emergency rooms and 156 healthy adults who had no head injuries. The average age of the group was 40. After their injury, participants were given up to three neurological assessments, at two weeks, six months, and one year. Each of these assessments yielded five scores from three measures of recall, language skills, and other cognitive domains.

The criteria for cognitive impairment, cognitive decline, or both were used to determine a poor cognitive outcome. Lower-than-expected performance on at least two cognitive tests, such as one memory test and one processing speed test, was defined as cognitive impairment. Cognitive decline was defined as a clinically significant decrease on at least two cognitive tests.

One year later, researchers discovered that 86 out of 656 individuals with mild brain injuries, or 14%, had poor cognitive results. 10% of those surveyed had only cognitive impairment, 2% had only cognitive decline, and 2% had both. In comparison, eight out of 156 participants (or 5%) without concussions had poor cognitive results one year later. Merely 3% of the healthy people had cognitive impairment, none had only cognitive decline, and 1% had both.

Additionally, researchers discovered that individuals who were depressed prior to their injury, did not have health insurance, or had less than a high school education were more likely to have a poor cognitive outcome than those who were not depressed prior to their injury, had health insurance, or had higher education.

One year after a concussion, persons who had good cognitive outcomes were more likely to have better life satisfaction, according to researchers. The participants were given a life satisfaction test with a score ranging from five to 35, with lower scores indicating lower life satisfaction. The participants who had favorable cognitive results scored an average of 26 on the test, compared to 21 for those who had poor cognitive outcomes.

The study does not prove that those who have had concussions have poorer cognitive outcomes a year later, but it does show a link.

“Previous studies of people with moderate to severe brain injuries show that early, intensive rehabilitation can improve people’s cognitive outcomes over time. More research is needed to find out the role of cognitive rehabilitation on people with more mild brain injuries who are also at risk for poor cognitive outcomes, and how to predict who falls into this risk category,” Gardner adds.

A limitation of the study is that people were enrolled at the time of their concussion and their cognitive health before injury was not known.

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