The relationship between neuropsychologic function and level of caregiver supervision at 1 year after traumatic brain injury.
OBJECTIVE
To evaluate distribution of levels of caregiver supervision at 1 year after traumatic brain injury, and to determine neuropsychologic predictors of supervision level.


METHODS
Prospective longitudinal design, concurrent measurement of neuropsychologic function and supervision level.


METHODS
Seventeen Traumatic Brain Injury Model Systems centers.


METHODS
A total of 563 adults tested at 1 year postinjury; and a subgroup of 452 studied for neuropsychologic function in the absence of impairment in mobility or basic self-care, as assessed by high FIM instrument motor scores.


METHODS
Not applicable.


METHODS
Supervision level measured by scores on Supervision Rating Scale (SRS).


RESULTS
Two thirds (69%) of the sample was rated as independent of supervision. Participants without significant dysfunction on motor FIM were grouped into supervision groups differing in intensity of time commitment from caregiver (independent, moderate supervision, heavy supervision). In univariate analyses, groups differed on demographic variables (education, race, productivity prior to injury), duration of altered consciousness, and all but 1 neuropsychologic measure. A binomial regression model (complementary log-log model) revealed that supervision at 1 year was predicted by education and scores on the Trail Making Test Part B and digits backward.


CONCLUSIONS
Findings confirm the importance of preinjury status and measures of working memory and cognitive flexibility in predicting functional independence after TBI. The SRS appears prone to ceiling effects in persons followed prospectively after moderate to severe TBI.
Hart
Tessa
T
Moss Rehabilitation Research Institute, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA, USA. thart@einstein.edu
Millis
Scott
S
Novack
Thomas
T
Englander
Jeffrey
J
Fidler-Sheppard
Rebecca
R
Bell
Kathleen R
KR
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001930:Brain Injuries / Q000534:rehabilitation*; D017028:Caregivers; D003071:Cognition; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D016014:Linear Models; D008297:Male; D008568:Memory; D008875:Middle Aged; D009483:Neuropsychological Tests; D012372:ROC Curve; D020127:Recovery of Function; D012044:Regression Analysis; D012648:Self Care