1. The relationship between agitation and impairments of orientation and memory during the PTA period after traumatic brain injury
- Author
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Jennie Ponsford, Jacinta Gracey, Jasmine Love, Adam McKay, and Jessica Trevena-Peters
- Subjects
Adult ,Male ,030506 rehabilitation ,medicine.medical_specialty ,Time Factors ,Adolescent ,Traumatic brain injury ,Period (gene) ,Amnesia ,Comorbidity ,Severity of Illness Index ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Physical medicine and rehabilitation ,Arts and Humanities (miscellaneous) ,Orientation (mental) ,Orientation ,Brain Injuries, Traumatic ,medicine ,Humans ,Cognitive Dysfunction ,Psychomotor Agitation ,Applied Psychology ,business.industry ,Rehabilitation ,Age Factors ,Cognition ,Middle Aged ,medicine.disease ,nervous system diseases ,Inhibition, Psychological ,Neuropsychology and Physiological Psychology ,nervous system ,Impulsive Behavior ,Multilevel Analysis ,Female ,medicine.symptom ,0305 other medical science ,business ,030217 neurology & neurosurgery ,Follow-Up Studies - Abstract
Agitation is common during the post-traumatic amnesia (PTA) period after traumatic brain injury (TBI), although our knowledge of what causes or predicts agitation is limited. The current study aimed to examine the association of agitation in PTA with the concurrent impairments in orientation and memory while controlling for covariates of agitation. Participants were 125 patients in PTA following moderate to extremely severe TBI recruited from an inpatient brain injury rehabilitation service who were assessed throughout PTA on the Agitated Behavior Scale (ABS) and the Westmead PTA Scale (WPTAS). Agitation was observed in 42.4% of participants (ABS score 21), with disinhibited behaviours (e.g., distractibility and impulsivity) most common. Multilevel modelling found daily ABS scores to be associated with daily scores on the WPTAS but in a non-linear pattern. Analysis of covariates found that shorter time post-admission, younger age, presence of infection and higher antipsychotic doses were associated with higher ABS scores. These results support a relationship between agitation and the concurrent cognitive impairment during PTA. While a causal link cannot yet be inferred, management strategies that can potentially interfere with cognition (e.g., sedating medications, environmental changes) should be used cautiously in case they exacerbate agitation.
- Published
- 2018
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