Evelyn Zepeda1, Asia Walter2, Amanda Fang2, Stephania Tovar Vargas2, Maral Sakayan3, Maria Thereza Paulino3, Alexis Conrad4, Arunima Kapoor3, Danh Nguyen2, Seyed Ali Sajjadi3, Mark Mapstone5, Michael Lopez3, Bernadette Boden-Albala6, Patrick Chen7
1UC Irvine Department of Neurology, 2UC Irvine, 3UCI Department of Neurology, 4Neurology Traumatic Brain Injury & Concussion (NTBIC) Program, Department of Neurology, University of California, Irvine, Orange, CA, 5University of California, Irvine, 6University California Irvine, 7UC Irvine Medical Center
Objective:
To examine the relationship between dementia risk factors on cognitive outcomes in TBI clinic patients.
Background:
Traumatic brain injury (TBI) can lead to cognitive impairment and is a risk factor for dementia, yet predictors of post-injury cognitive outcomes remain poorly understood. Montreal Cognitive Assessment (MoCA) is a screening tool that evaluates cognitive impairment across cognitive domains. Factors like multiple lifetime TBI’s, poor brain health, lack of insurance and education are risk factors for Alzheimer’s dementia, but their role in cognitive impairment post-mTBI is unclear. We hypothesize that the same risk factors in dementia are associated with lower MoCA performance post-TBI.
Design/Methods:
Retrospective cohort study of TBI seen in a clinic setting [UCI-NTBIC database (9/2022–6/2025)]. Inclusion criteria: patients ≥18 years old, TBI per American College of Rehabilitation (ACRM) Criteria. Exclusion: premorbid dementia, unable to complete MoCA secondary to disability. Primary exposures: McCance Brain Care Score as brain health measure (21-point questionnaire), self-reported number of TBI, Insurance Status Scale, Level of Education Scale. Primary outcome: MoCA score, with ≥ 26 considered within normal cognitive range. Descriptive statistics, multivariable logistic regression, Spearman correlation, and beta coefficient analyses were performed.
Results:
Among the 99 patients studied (mean age 47, 51% male, 76.5% mild TBI) no risk factor independently predicted poor MoCA outcome on regression. However, insurance coverage (β =1.67, p =0.0256), level of education (β = 1.08, 0.050), and McCance Brain Care Score (β = 0.450, p = 0.0435) were each significantly associated with MoCA scores. Conclusions:
Our exploratory findings suggest that greater insurance coverage, higher educational attainment, and higher braincare scores are associated with better cognitive outcomes post-TBI. Future work will assess how these factors influence cognitive trajectories over time in longitudinal follow-up.
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.