Neurocognitive status and return to work after moderate to severe traumatic brain injury

Model System:

TBI

Reference Type:

Journal article

Accession No.:

J84134

Journal:

Rehabilitation Psychology

Year, Volume, Issue, Page(s):

2019 , 64, 4, 435-444

Publication Website:

Abstract:

Study examined the relationship between cognitive status to employment status 1 year after moderate-severe traumatic brain injury (TBI). Three hundred twenty people with moderate-severe TBI, all employed at injury, were enrolled during inpatient rehabilitation in a TBI Model System center and evaluated at 1-year postinjury. Follow-up measures included whether and when participants had returned to work (RTW), and cognitive status assessed with the Brief Test of Adult Cognition by Telephone (BTACT). Multivariable logistic regression and survival analyses were used to assess the contribution of BTACT (overall and subscale scores) to employment outcomes, controlling for covariates with known associations to those outcomes, including demographic variables, injury severity, and driving status. Results indicated that fewer than 40 percent of participants (124) were employed at 1-year follow-up. BTACT scores were strongly associated with RTW even after controlling for known covariates. Females had faster and higher rates of RTW compared to males. Resumption of driving and injury severity were also related to RTW. Neurocognitive status is a potentially modifiable factor with an important relationship to RTW following TBI. Vocational rehabilitation efforts should provide cognitive remediation or compensation as well as addressing transportation barriers. As a brief telephone-based assessment, the BTACT offers a new and efficient tool for evaluation of episodic memory and executive function.

Author(s):